National database study on the use of long-acting antipsychotic injections and hospital readmission proportions in patients with schizophrenia in Japan

Comparison of health resource usage and costs associated with first-generation and second-generation long-acting injectable antipsychotics for patients with schizophrenia: A nationwide population-based cohort study

The aim of this study was to examine psychiatric resource utilization, medical costs and clinical outcomes for patients with schizophrenia who received either first-generation or second-generation long-acting injectable (LAI) antipsychotics. A retrospective cohort study was conducted using data from Taiwan's National Health Insurance Research Database (NHIRD). Patients who began either first-generation or second-generation LAI treatment between 2015 and 2017 were enrolled and followed for three years. The data were evaluated using survival analysis and Cox proportional hazards regression models. Our findings demonstrated that both first- and second-generation LAI therapies led to notable reductions in the frequency of psychiatric hospitalizations and the duration of hospital stays when compared to the initial measurements. Additionally, the second-generation LAI group exhibited significantly lower rates of psychiatric emergencies and hospitalizations, as well as shorter hospital stays, compared to the first-generation LAI group. However, it is worth noting that the second-generation LAI group incurred higher pharmacy fees despite these favorable outcomes. The utilization of both first- and second-generation LAIs can enhance medication adherence and decrease the risk of acute exacerbation in patients with schizophrenia. These findings hold significant implications for schizophrenia management and the efficient allocation of healthcare resources.

Improvements in the degree of understanding the treatment guidelines for schizophrenia and major depressive disorder in a nationwide dissemination and implementation study

BACKGROUND

To implement clinical practice guidelines (CPGs), it is necessary for psychiatrists to deepen their understanding of the CPGs. The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project is a nationwide dissemination and implementation study of two sets of CPGs for schizophrenia and major depressive disorder (MDD).

METHODS

A total of 413 psychiatrists (n = 212 in 2016; n = 201 in 2017) learned the two CPGs in the education program of the EGUIDE project, and clinical knowledge of these CPGs was evaluated at baseline and after the programs. To improve the correct answer rate for clinical knowledge after the programs, we revised the lecture materials associated with items that had a low correct answer rate in 2016 and used the revised lecture materials with the CPGs in 2017. The rates of correct answers after the programs between the 2016 and 2017 groups were compared.

RESULTS

The correct answer rate of one item on the schizophrenia CPG and one item on the MDD CPG tended to be improved (S-D5 and D-C6) and that of one on the MDD CPG was significantly improved (D-D3, P = 0.0008) in the 2017 group compared to those in the 2016 group.

CONCLUSIONS

We reported improvements in clinical knowledge of CPGs after the EGUIDE program in the 2017 group following revision of the lecture materials based on results from the 2016 group. These attempts to improve the degree of understanding of CPGs may facilitate the successful dissemination and implementation of psychiatric guidelines in everyday practice.

Retraction statement: National database study on the use of long-acting antipsychotic injections and hospital readmission proportions in patients with schizophrenia in Japan

Usuki M, Kamiura Y, Okubo R, Yamanouchi Y. National database study on the use of long-acting antipsychotic injections and hospital readmission proportions in patients with schizophrenia in Japan. Psychiatry Clin. Neurosci. 2020; 74: 211-217. https://doi.org/10.1111/pcn.12970 The above article from Psychiatry and Clinical Neurosciences, published online on 3 February 2020 in Wiley Online Library (www.onlinelibrary.wiley.com), and in Volume 74, pp. 211-217, has been retracted by agreement between the authors, the Editors-in-Chief, Shigenobu Kanba and Tadafumi Kato, and John Wiley & Sons Australia Ltd. The retraction has been issued because the Ministry of Health, Labour and Welfare (MHLW) announced that the authors violated the guidelines on the use of the data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB Japan) in the article. REFERENCE: Usuki M, Kamiura Y, Okubo R, Yamanouchi Y. National database study on the use of long-acting antipsychotic injections and hospital readmission proportions in patients with schizophrenia in Japan. Psychiatry Clin. Neurosci. 2020; 74: 211-217. https://doi.org/10.1111/pcn.12970.