Long Acting Injectable versus Oral Antipsychotics in Reducing Hospitalization Outcomes in Schizophrenia: A Mirror-Image Study

Abstract

Objective: The primary objective of this study was to assess the difference of hospitalization rates when switching patients with schizophrenia from oral antipsychotics to Long Acting Injectable (LAI) antipsychotic medications. Methods: A single centre mirror image design study of 44 patients was conducted in a community centre hospital. Data surrounding hospitalization was collected 12 months before and 12 months after switching from oral to LAI. Results: There was a 91% reduction in ward admissions and an 80% reduction in ER visits when switched to LAI (p<0.001). Of the 44 patients, 32 were admitted at least once whilst on oral therapy; after switching to LAI, only 5 patients were admitted. The total number of days spent on the ward on oral therapy was 1347 days, versus 59 days on LAI. After switching to LAI from oral therapy, mean length of stay in hospital per patient decreased by 30 days (p<0.001). Cost benefit analysis showed a net savings of $805,798.80 for 44 patients over the course of one year. Conclusions: The data from this study suggests that long acting injectable therapy is strongly superior to oral antipsychotics for the treatment of schizophrenia. A significant reduction in hospitalization rates and costs was seen.