Drug Utilization of Japanese Patients Diagnosed with Schizophrenia: An Administrative Database AnalysisReport as inadecuate




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Clinical Drug Investigation

, Volume 37, Issue 6, pp 559–569

First Online: 30 March 2017DOI: 10.1007-s40261-017-0517-0

Cite this article as: Cheung, S., Hamuro, Y., Mahlich, J. et al. Clin Drug Investig 2017 37: 559. doi:10.1007-s40261-017-0517-0

Abstract

Background and objectivePatient characteristics require consideration for optimal treatment in order to achieve clinical remission for an improved quality of life and social functioning. Prior evidence supports long-acting injectable antipsychotics LAIs in the relapse prevention of schizophrenia. This study aimed to characterize Japanese patients diagnosed with schizophrenia and to compare the outcomes of LAIs and oral antipsychotics AP in re-hospitalization or emergency room visit rates.

MethodsDiagnostic Procedure Combination DPC designated hospital data in Japan with ICD-10 code F20x between July 2013 and June 2015 were obtained from the Medical Data Vision Co. Ltd. Patients were divided into sub-groups in order to filter co-diagnostic conditions. Differences across sub-groups were assessed using a Chi square test or ANOVA. The incidence rate ratio IRR was calculated to compare the re-hospitalization 30 days post discharge or emergency room visit rates between pharmacotherapy groups of oral versus LAI or typical versus atypical within LAI patients. Adjusted estimates were provided by propensity scores that were assigned for age, gender, and Charlson co-morbidity index CCI scores.

ResultsA quarter of the data sourced were attributed to co-diagnosis with dementia-delirium with antipsychotic prescriptions despite reported risks of antipsychotic use. After adjusting for age, gender, and co-morbidity, LAI reduced re-hospitalization and emergency ER visit rates more than oral APs LAI vs. oral IRR = 0.38 95% CI 0.17–0.74, IRR = 0.56 95% CI 0.34–0.91, respectively.

ConclusionThe study findings demonstrate usage of DPC hospital data in schizophrenia pharmacotherapy based on classification of co-diagnoses. In comparison with oral APs only, LAI utilization can provide an opportunity for reduced re-hospitalization and ER visit rates among patients with schizophrenia.





Author: Stephane Cheung - Yukinobu Hamuro - Jörg Mahlich - Takanobu Nakahara - Rosarin Sruamsiri - Sunny Tsukazawa

Source: https://link.springer.com/



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