Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System Encounters
**Background:** Nonadherence to medication is prevalent in persons diagnosed with schizophrenia, thus increasing the likelihood of relapse, poor health outcomes, hospitalization, high treatment costs, and high rates of both violent and non-violent offenses. **Objective:** To assess the association...
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2021-05-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/jheor.2021.22979 |
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| author | Madhav P. Bhatta Saroj Bista Antoine C. El Khoury Eric G. Hutzell Neeta Tandon Douglas Smith |
| author_facet | Madhav P. Bhatta Saroj Bista Antoine C. El Khoury Eric G. Hutzell Neeta Tandon Douglas Smith |
| author_sort | Madhav P. Bhatta |
| collection | DOAJ |
| description | **Background:** Nonadherence to medication is prevalent in persons diagnosed with schizophrenia, thus increasing the likelihood of relapse, poor health outcomes, hospitalization, high treatment costs, and high rates of both violent and non-violent offenses.
**Objective:** To assess the association between long-acting injectable (LAI) antipsychotic use and criminal justice system encounters in patients with schizophrenia or schizoaffective disorder.
**Methods:** This retrospective follow-up study was conducted among patients aged ≥18 years treated for schizophrenia or schizoaffective disorder at a community mental health center in Akron, Ohio, between January 1, 2010, and June 15, 2016. The incidence of criminal justice system encounters at 6 months, 1 year, and 2 years pre- versus post-LAI antipsychotic initiation was assessed. A subanalysis was conducted for individuals with a history of prior arrest.
**Results:** Overall, the risk ratio (RR) of having an encounter with the criminal justice system was significantly lower for patients treated with LAI antipsychotics 1 year after initiation of treatment compared with a similar time period prior to initiation (RR \[95% confidence interval (CI)\]: 0.74 \[0.59–0.93\]; *P*<0.01) and 2 years (0.74 \[0.62–0.88\]; *P*<0.0001). Statistically significant reductions in criminal justice system encounters after treatment than before treatment were observed in the once-monthly paliperidone palmitate (PP1M) cohort. The incidence of arrests was lower in the 6-month (27 vs 85 arrests), 1-year (46 vs 132 arrests) and 2-year (88 vs 196 arrests) periods post-index LAI medication than in the corresponding periods pre-index LAI medication among individuals with a history of prior arrest.
**Conclusions:** Patients with schizophrenia or schizoaffective disorder who were initiated on a LAI antipsychotic medication, specifically PP1M, were less likely to have an encounter with the criminal justice system compared with a similar time period before the initiation of LAI treatment. |
| format | Article |
| id | doaj-art-9bfc3fb8666746e3ba82afd47b9afb88 |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2021-05-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-9bfc3fb8666746e3ba82afd47b9afb882025-02-10T16:13:22ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362021-05-0181Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System EncountersMadhav P. BhattaSaroj BistaAntoine C. El KhouryEric G. HutzellNeeta TandonDouglas Smith**Background:** Nonadherence to medication is prevalent in persons diagnosed with schizophrenia, thus increasing the likelihood of relapse, poor health outcomes, hospitalization, high treatment costs, and high rates of both violent and non-violent offenses. **Objective:** To assess the association between long-acting injectable (LAI) antipsychotic use and criminal justice system encounters in patients with schizophrenia or schizoaffective disorder. **Methods:** This retrospective follow-up study was conducted among patients aged ≥18 years treated for schizophrenia or schizoaffective disorder at a community mental health center in Akron, Ohio, between January 1, 2010, and June 15, 2016. The incidence of criminal justice system encounters at 6 months, 1 year, and 2 years pre- versus post-LAI antipsychotic initiation was assessed. A subanalysis was conducted for individuals with a history of prior arrest. **Results:** Overall, the risk ratio (RR) of having an encounter with the criminal justice system was significantly lower for patients treated with LAI antipsychotics 1 year after initiation of treatment compared with a similar time period prior to initiation (RR \[95% confidence interval (CI)\]: 0.74 \[0.59–0.93\]; *P*<0.01) and 2 years (0.74 \[0.62–0.88\]; *P*<0.0001). Statistically significant reductions in criminal justice system encounters after treatment than before treatment were observed in the once-monthly paliperidone palmitate (PP1M) cohort. The incidence of arrests was lower in the 6-month (27 vs 85 arrests), 1-year (46 vs 132 arrests) and 2-year (88 vs 196 arrests) periods post-index LAI medication than in the corresponding periods pre-index LAI medication among individuals with a history of prior arrest. **Conclusions:** Patients with schizophrenia or schizoaffective disorder who were initiated on a LAI antipsychotic medication, specifically PP1M, were less likely to have an encounter with the criminal justice system compared with a similar time period before the initiation of LAI treatment.https://doi.org/10.36469/jheor.2021.22979 |
| spellingShingle | Madhav P. Bhatta Saroj Bista Antoine C. El Khoury Eric G. Hutzell Neeta Tandon Douglas Smith Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System Encounters Journal of Health Economics and Outcomes Research |
| title | Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System Encounters |
| title_full | Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System Encounters |
| title_fullStr | Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System Encounters |
| title_full_unstemmed | Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System Encounters |
| title_short | Long-Acting Injectable Antipsychotic Use in Patients with Schizophrenia and Criminal Justice System Encounters |
| title_sort | long acting injectable antipsychotic use in patients with schizophrenia and criminal justice system encounters |
| url | https://doi.org/10.36469/jheor.2021.22979 |
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