{"title":"Real-World Evidence of Aripiprazole Tablets with Sensor: Treatment Patterns and Impacts on Psychiatric Healthcare Resource Utilization.","authors":"Dusica Hadzi Boskovic, Shuting Liang, Purva Parab, Emily Wiggins, Joshua N Liberman","doi":"10.2147/CEOR.S402357","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Maintaining adherence to antipsychotic (AP) medication is often challenging. Aripiprazole tablets with sensor (AS) contain an ingestible event marker and communicate with wearable patches and a smartphone app to provide objective medication ingestion data. This study evaluated real-world treatment patterns of AS usage and its impact on psychiatric healthcare resource utilization (HCRU).</p><p><strong>Patients and methods: </strong>This retrospective, observational cohort study identified individuals who initiated AS between 1/1/2019 and 6/30/2020 with 3 months baseline and 6 months of follow-up data using a commercial medical and pharmacy claims database (Clarivate). Controls were propensity score-matched (4:1) to AS initiators based on age (±2 years), sex, diagnosis (major depressive disorder [MDD], schizophrenia, bipolar I disorder [BP-I], other), insurance, and baseline oral AP use (yes/no). Days of AP supply were evaluated using a general regression model. The frequency of psychiatric HCRU during follow-up was compared between groups using a zero-inflated regression model.</p><p><strong>Results: </strong>Most AS initiators were diagnosed with MDD (61.2%) and were women (61.2%); mean age was 37.7 years (standard deviation: 14.1). Most AS initiators (53.1%) continued treatment for >60 days (mean days of supply = 77). After adjusting for covariates, AS initiators had 41% more days of AP supply during follow-up compared with controls (<i>P</i> <0.0001) and significantly lower adjusted odds ratios (ORs) for psychiatric outpatient visits (adjusted OR = 0.80; <i>P</i> <0.05), emergency department visits (adjusted OR = 0.11; <i>P</i> <0.05), inpatient visits (adjusted OR = 0.42; <i>P</i> <0.05), and other medical services (adjusted OR = 0.25; <i>P</i> <0.05).</p><p><strong>Conclusion: </strong>Participants who implemented AS had significantly more days of AP supply and fewer psychiatric care visits. These preliminary results suggest AS usage can help build regular medication-taking habits and holds promise for reducing psychiatric HCRU. Additional studies with larger sample sizes are warranted to inform clinical practice and coverage decisions.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/38/ceor-15-487.PMC10292208.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ClinicoEconomics and Outcomes Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/CEOR.S402357","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 1
Abstract
Purpose: Maintaining adherence to antipsychotic (AP) medication is often challenging. Aripiprazole tablets with sensor (AS) contain an ingestible event marker and communicate with wearable patches and a smartphone app to provide objective medication ingestion data. This study evaluated real-world treatment patterns of AS usage and its impact on psychiatric healthcare resource utilization (HCRU).
Patients and methods: This retrospective, observational cohort study identified individuals who initiated AS between 1/1/2019 and 6/30/2020 with 3 months baseline and 6 months of follow-up data using a commercial medical and pharmacy claims database (Clarivate). Controls were propensity score-matched (4:1) to AS initiators based on age (±2 years), sex, diagnosis (major depressive disorder [MDD], schizophrenia, bipolar I disorder [BP-I], other), insurance, and baseline oral AP use (yes/no). Days of AP supply were evaluated using a general regression model. The frequency of psychiatric HCRU during follow-up was compared between groups using a zero-inflated regression model.
Results: Most AS initiators were diagnosed with MDD (61.2%) and were women (61.2%); mean age was 37.7 years (standard deviation: 14.1). Most AS initiators (53.1%) continued treatment for >60 days (mean days of supply = 77). After adjusting for covariates, AS initiators had 41% more days of AP supply during follow-up compared with controls (P <0.0001) and significantly lower adjusted odds ratios (ORs) for psychiatric outpatient visits (adjusted OR = 0.80; P <0.05), emergency department visits (adjusted OR = 0.11; P <0.05), inpatient visits (adjusted OR = 0.42; P <0.05), and other medical services (adjusted OR = 0.25; P <0.05).
Conclusion: Participants who implemented AS had significantly more days of AP supply and fewer psychiatric care visits. These preliminary results suggest AS usage can help build regular medication-taking habits and holds promise for reducing psychiatric HCRU. Additional studies with larger sample sizes are warranted to inform clinical practice and coverage decisions.
目的:维持抗精神病药物(AP)的依从性通常具有挑战性。带有传感器(AS)的阿立哌唑片包含一个可摄入事件标记,并与可穿戴贴片和智能手机应用程序通信,以提供客观的药物摄入数据。本研究评估现实世界中AS使用的治疗模式及其对精神卫生保健资源利用(HCRU)的影响。患者和方法:这项回顾性、观察性队列研究确定了2019年1月1日至2020年6月30日期间发病的AS患者,使用商业医疗和药房索赔数据库(Clarivate)进行了3个月的基线和6个月的随访数据。对照者根据年龄(±2岁)、性别、诊断(重度抑郁症[MDD]、精神分裂症、双相I型障碍[BP-I]、其他)、保险和基线口服AP使用情况(是/否)与AS启动者进行倾向评分匹配(4:1)。使用一般回归模型评估AP供应天数。随访期间精神科HCRU发生频率采用零膨胀回归模型进行组间比较。结果:大多数AS启动者被诊断为重度抑郁症(61.2%),且为女性(61.2%);平均年龄37.7岁(标准差:14.1)。大多数AS启动者(53.1%)持续治疗>60天(平均供应天数= 77天)。在调整协变量后,与对照组相比,AS启动者在随访期间的AP供应天数增加了41% (P P P P P P P)结论:实施AS的参与者的AP供应天数明显增加,精神科护理就诊次数明显减少。这些初步结果表明,使用AS可以帮助建立有规律的服药习惯,并有望减少精神科HCRU。有必要进行更多样本量更大的研究,为临床实践和覆盖决策提供信息。