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Gilbert JL, Nelson LA, Kriz CR, Liu Y, Iuppa CA, Diefenderfer LA, Elliott ESR, Sommi RW. Identifying Predictors of Primary Adherence to Second Generation Long-Acting Injectable Antipsychotics Following Discharge from an Acute Inpatient Psychiatry Unit. PSYCHOPHARMACOLOGY BULLETIN 2019; 49:8-16. [PMID: 31308578 PMCID: PMC6598778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Describe primary adherence and medication persistence to second generation long-acting injectable (LAI) antipsychotics following an inpatient psychiatry hospitalization, compare rates of psychiatric-related hospital readmissions and emergency visits within 6 months of discharge between patients who were adherent versus nonadherent, and explore predictors of primary adherence to second generation LAI antipsychotics following hospitalization. EXPERIMENTAL DESIGN This retrospective chart review included patients who received at least 1 dose of a second-generation LAI antipsychotic while hospitalized in an acute care psychiatry unit between April 1, 2016 and July 31, 2017, had active Missouri Medicaid, and continued on the second-generation LAI antipsychotic upon discharge. Patients were excluded if they were discharged to a care setting where medication was administered. PRINCIPAL OBSERVATIONS Seventy-five charts were included. Primary adherence rate was 37% and only 46% of those persisted with LAI antipsychotic treatment over a 6-month time period following discharge. Rates of psychiatric-related readmission or emergency visit within 6 months post-discharge did not differ between groups. No statistically significant correlations between primary adherence and demographic or socioeconomic variables were found. CONCLUSIONS Primary adherence and medication persistence to second generation LAI antipsychotics following hospital discharge is low with approximately 60% of patients not receiving another injection. Clinicians should consider outpatient medication adherence before initiating a second-generation LAI antipsychotic during hospitalization. Efforts should be made to facilitate adherence to LAI antipsychotics during transition of care from inpatient to outpatient settings.
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Affiliation(s)
- Jenna L Gilbert
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
| | - Leigh Anne Nelson
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
| | - Carrie R Kriz
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
| | - Yifei Liu
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
| | - Courtney A Iuppa
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
| | - Lauren A Diefenderfer
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
| | - Ellie S R Elliott
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
| | - Roger W Sommi
- Gilbert, Pharm.D, BCPP, PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, MO. Nelson, Pharm.D, BCPP, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, and Truman Medical Center, Kansas City, MO. Kriz, MS, Clinical Coordinator/Research Assistant and Liu, B.S. Pharm, Ph.D, Associate Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO. Iuppa, Pharm.D, BCPP, Residency Program Director/Clinical Pharmacy Manager, Diefenderfer, Pharm.D, BCPP Clinical Pharmacist, and Elliott, Pharm.D, BCPP, Director of Pharmacy, Center for Behavioral Medicine, Kansas City, MO. Sommi, Pharm.D, BCPP, FCCP, Associate Dean, UMKC School of Pharmacy at MU, Vice Chair, Division of Pharmacy Practice and Administration, Professor, Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO
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