Patients with a psychiatric disorder other than schizophrenia as primary diagnosis were excluded. This was a multicenter, observational, retrospective, and non-interventional study that included adult patients (age ≥ 18 years) diagnosed with schizophrenia who were initiated on AOM treatment (before November 1 st, 2016 and up to January 2015) during a schizophrenia-related hospitalization at least six months before data collection. In the present non-interventional study, we intend to evaluate the impact of patient demographic and clinical characteristics on AOM persistence (understood as time from treatment initiation up to treatment discontinuation for any reason) during the first six months of treatment in patients starting AOM after being stabilized from an acute psychotic relapse and prior to discharge following Spanish clinical practice. (2018) retrospectively analyzed 82 patients with schizophrenia in which AOM outpatient initiation and no-history of hospitalizations were significantly associated with lower AOM discontinuations. DOMINO study, which included 261 patients with schizophrenia, found higher treatment adherence among patients with baseline Clinical Global Impression (CGI) score < 5, lifetime schizophrenia dimension mania score < 6, and psychotic spectrum schizoid score < 12. However, few observational studies have assessed predictors of persistence with AOM treatment in patients with schizophrenia. A mixed-treatment comparison of RCTs found lower AOM discontinuation rates due to adverse events (AEs) compared to other LAI AP, and recent studies support significant evidence in relapse prevention with AOM versus previous treatments. Ĭontributing factors to AP treatment non-adherence had been previously studied, highlighting lack of insight, medication beliefs, side effects/tolerability issues, prior poor adherence and substance abuse as key drivers of non-adherence.Īripiprazole once-monthly (AOM) is an atypical second-generation AP with proven efficacy and tolerability for schizophrenia treatment. Despite meta-analyses of randomized controlled trials (RCTs) showed no advantages in relapse prevention associated with LAI AP in comparison with oral AP, those analyses closer to real clinical practice support clear evidence for LAI AP superiority on hospital admission prevention. Long-acting injectable (LAI) AP allow early non-adherence detection, facilitating corrective measures implementation to improve treatment adherence. Some systematic reviews reveal that almost 80% of patients are partially or totally non-adherent to oral AP. Non-adherence to antipsychotic (AP) drugs is one of the most important risk factors for relapse and hospitalization. Hence, identifying main patient, disease and treatment factors contributing to lower adherence rates, as well as defining better strategies to improve treatment-adherence, is crucial in schizophrenia management. Previous studies point the high relapse rate in schizophrenia, even after a single psychosis episode. Similarly, very recent publications showed that duration of active psychotic symptoms after commencing treatment (DAT) strongly impacts long-term functional outcomes in schizophrenia. Active psychotic episodes impact negatively on the illness course favoring disease progression and treatment refractoriness emergence, and preventing patients from recovering their previous functional and quality of life levels. Schizophrenia is a severe, chronic disabling disorder with most patients suffering repeated relapses.
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