Recovery outcomes of schizophrenia patients treated with paliperidone palmitate in a community setting: patient and provider perspectives on recovery

J Med Econ. 2016;19(5):469-76. doi: 10.3111/13696998.2015.1131989. Epub 2015 Dec 31.

Abstract

Objectives: This study evaluated the effect of paliperidone palmitate long-acting injectable (LAI) antipsychotic on recovery-oriented mental health outcomes from the perspective of healthcare providers and patients during the treatment of patients with schizophrenia or schizoaffective disorders.

Methods: Archival data for patients with a primary diagnosis of schizophrenia or schizoaffective disorder receiving ≥6 months of paliperidone palmitate LAI were retrieved from the electronic medical records system at the Mental Health Center of Denver. Mental health recovery was assessed from both a provider's (Recovery Markers Inventory [RMI]) and patient's (Consumer Recovery Measure [CRM]) perspective. A three-level hierarchical linear model (HLM) was utilized to determine changes in CRM and RMI scores by including independent variables in the models: intercept, months from treatment (slope), treatment time period (pretreatment and treatment), age, gender, primary diagnosis, substance abuse diagnosis, concurrent medications, and adherence to paliperidone palmitate LAI.

Results: A total of 219 patients were identified and included in the study. Results of the final three-level HLMs indicated an overall increase in CRM scores (p < 0.05), an overall increase (p < 0.01), and an increased rate of change (p < 0.05) in RMI scores during the paliperidone palmitate LAI treatment period vs the pre-treatment period.

Limitations: This study contained a retrospective, non-comparative design, and did not adjust for multiplicity Conclusions: The current study demonstrates that changes in recovery-oriented mental health outcomes can be detected following the administration of a specific antipsychotic treatment in persons with schizophrenia or schizoaffective disorders. Furthermore, patients receiving paliperidone palmitate LAI can effectively improve recovery-oriented outcomes, thereby supporting the drug's use as schizophrenia treatment from a recovery-oriented perspective.

Keywords: Long-acting injectable antipsychotics; Paliperidone palmitate LAI; Recovery-oriented mental health outcomes; Schizophrenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use*
  • Delayed-Action Preparations
  • Ethnicity
  • Female
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Paliperidone Palmitate / administration & dosage
  • Paliperidone Palmitate / therapeutic use*
  • Prisons / economics
  • Prisons / statistics & numerical data
  • Psychometrics
  • Psychotic Disorders / drug therapy*
  • Retrospective Studies
  • Schizophrenia / drug therapy*
  • Social Support
  • Substance Abuse Treatment Centers / economics
  • Substance Abuse Treatment Centers / statistics & numerical data
  • Time Factors
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations
  • Paliperidone Palmitate