Mental healthcare utilisation by patients before and after receiving paliperidone palmitate treatment: mirror image analyses. Issue 4 (6th April 2022)

• Record Type: Journal Article
• Authors: Kadra-Scalzo, Giouliana; Ahn, Deborah; Bird, Alex; Broadbent, Matthew; Chang, Chin-Kuo; Pritchard, Megan; Shetty, Hitesh; Taylor, David; Hayes, Richard; Stewart, Robert
• Is Part Of: BMJ open. Volume 12:Issue 4(2022)
• Publication Date: 2022-04-06
• Subjects: mental health -- adult psychiatry -- schizophrenia & psychotic disorders; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-051567
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To compare mental healthcare use and healthcare professional (HCP) contacts for patients before and after initiation of paliperidone palmitate. Setting: The South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre Clinical Record Interactive Search. Participants: We identified all adults with a diagnosis of schizophrenia (International Classification of Diseases 10th Revision: F20.x), who had received paliperidone palmitate prescription for at least 365 days and had at least 1 year of recorded treatment from SLAM, prior to the first recorded receipt of paliperidone palmitate. Primary and secondary outcome measures: Inpatient and community mental healthcare service use, such as inpatient bed days, number of active days in the service, face-to-face and telephone HCP use in the 12 months before and after paliperidone palmitate initiation. Results: We identified 664 patients initiated on paliperidone palmitate. Following initiation, inpatient bed days were lower, although patients remained active on the service case load longer for both mirror approach 1 (mean difference of inpatient bed days −10.48 (95% CI −15.75 to −5.22); days active 40.67 (95% CI 33.39 to 47.95)) and mirror approach 2 (mean difference of inpatient bed days −23.96 (95% CI −30.01 to −17.92); mean difference of days active 40.69 (95% CI 33.39 to 47.94)). The postinitiation period was further characterised by fewer face-to-face and telephone contacts with medical and social work HCPs, and an increased contact with clinical psychologists. Conclusions: Our findings indicate a change in the profile of HCP use, consistent with a transition from treatment to possible rehabilitation.