Evaluation of the impact of long-acting antipsychotic use in a Canadian First Episode Psychosis Clinic: A mirror study.


E. Sadeh, A. Blackwood, S. Robertson

First Episode Psychosis patients are more responsive to antipsychotic medications with 87% response rate in the first year and at lower doses. However, high medication non-adherence or partial adherence rates in this population reduce the effect of treatment and increase risk of relapse. Thus, the use of long-acting injectable (LAI) antipsychotics is recommended as an important treatment option. A mirror study, which compared one year periods pre and post LAI administration in the same patients, was used to evaluate the treatment impact. Data were collected through a retrospective chart review for all patients with a schizophrenia spectrum diagnosis who were treated with any LAI in a First Episode Psychosis clinic in Ottawa, Ontario from June 2012 to June 2017. Forty patients met inclusion criteria; patients were mainly white (62.5%), male (68%), completed high school (61.1%), received disability support (45%), living with their parents (89%) and average age of 23 years (SD=4.3). The most common reason for starting LAI was poor and partial compliance with oral forms (67.5%). Following the LAI treatment, hospitalization (p<0.0001) and length of hospital stay decreased significantly (p=0.004). There were no significant statistical differences in ER visits and rating medical scales including PANSS, GAF, and CGI scores before and after LAI treatment. The results support that LAI treatment may prevent recurrence of and reduce the risk of hospitalization. The main limitation of this study was a small sample size and lack of rating medical scales prior to LAI start for some of the eligible patients.

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