Hospital Utilization Rates Following Antipsychotic Dose Reductions Among Patients With Schizophrenia

December 21, 2017
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This poster was presented at the 30th annual  Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.

Introduction: Tardive dyskinesia (TD), an often-irreversible movement disorder, develops in patients treated with antipsychotics. Although antipsychotic dose reduction has been utilized in the management of TD, the benefits and risks of lowering doses have not been well studied and could cause additional burden to patients.

Objective: To analyze the healthcare burden of antipsychotic dose reduction in patients with schizophrenia.

Methods: Medical claims from six US states spanning 6 years are retrospectively analyzed for ≥10% or ≥30% antipsychotic dose reductions and compared with those from patients receiving stable doses. Outcomes measured include inpatient admissions and emergency room (ER) visits for schizophrenia, all psychiatric disorders, and all causes.

Results: Baseline analysis revealed 17,984 patients with ≥10% and 14,029 patients with ≥30% dose reduction. Patients with ≥10% dose reduction and matched controls were similar in age (mean 45.5 years), gender (51% male) and healthcare plan type. Preliminary analyses indicate that ≥10% dose reduction is associated with increased risk of admission or ER visit for schizophrenia (hazard ratio [HR] 1.26; 95% confidence interval [CI] 1.18, 1.35; P<0.001) and all psychiatric disorders (HR 1.18; 95% CI 1.11, 1.25; P<0.001) versus controls, which may be even greater with ≥30% dose reduction. Final updated results of ongoing analyses will be presented at the meeting.

Conclusions: Patients with antipsychotic dose reductions may be at risk for significant increases in hospital utilization rates. This suggests that dose reductions may increase overall healthcare burden in some schizophrenia patients, and highlights the need for alternative strategies in the management of TD.

Authors: 
Stanley Caroff, MD; Fan Mu, PhD; Rajeev Ayyagari, PhD; Traci Schilling, MD; Victor Abler, DO; Benjamin Carroll, PharmD
Sponsoring Organization: 
Teva Pharmaceutical Industries
Year: 
2017
Tracks: 
Psychotic Disorders
Mood Disorders