Table 3.
Summary of healthcare utilization during the 12-month period after first evidence of second-generation oral antipsychotic therapy use, by adherence and persistence status
| All patients | Adherenta | Non- adherent | P valueb | Persistenta | Non-persistent | P valuec | |
|---|---|---|---|---|---|---|---|
| Psychiatric-related relapse eventsc | |||||||
| Number of relapse events | |||||||
| Mean (SD) | 4.01 (3.34) | 3.85 (3.28) | 4.13 (3.37) | 0.012 | 3.81 (3.20) | 4.21 (3.46) | <0.001 |
| Median | 3.00 | 3.00 | 3.00 | 3.00 | 3.00 | ||
| All-cause and schizophrenia-related healthcare utilization | |||||||
| Had ≥1 encounter, n (%) | 3714 (100.00) | 1673 (100.00) | 2041 (100.00) | – | 1856 (100.00) | 1858 (100.00) | – |
| Had ≥1 schizophrenia-related encounter, n (%) | 3714 (100.00) | 1673 (100.00) | 2041 (100.00) | – | 1856 (100.00) | 1858 (100.00) | – |
| Number of encounters, mean (SD) | 153.14 (105.65) | 204.71 (109.84) | 110.86 (80.36) | <0.001 | 194.75 (108.77) | 111.57 (83.91) | <0.001 |
| Number of schizophrenia-related encounters, mean (SD) | 55.55 (60.27) | 77.16 (70.65) | 37.83 (42.69) | <0.001 | 72.59 (67.39) | 38.53 (46.33) | <0.001 |
| Had ≥1 medical (i.e. non-pharmacy) encounter, n (%) | 3714 (100.00) | 1673 (100.00) | 2041 (100.00) | – | 1856 (100.00) | 1858 (100.00) | – |
| Had ≥1 schizophrenia-related medical (i.e. non-pharmacy) encounter, n (%) | 3449 (92.86) | 1568 (93.72) | 1881 (92.16) | 0.066 | 1736 (93.53) | 1713 (92.20) | 0.113 |
| Number of medical encounters, mean (SD) | 78.53 (67.31) | 100.18 (78.00) | 60.79 (50.59) | <0.001 | 95.26 (75.40) | 61.82 (53.10) | <0.001 |
| Number of schizophrenia-related medical encounters, mean (SD) | 39.12 (55.37) | 53.08 (67.20) | 27.67 (39.84) | <0.001 | 49.77 (63.76) | 28.47 (42.92) | <0.001 |
| Had ≥1 pharmacy claim, n (%) | 3714 (100.00) | 1673 (100.00) | 2041 (100.00) | – | 1856 (100.00) | 1858 (100.00) | – |
| Had ≥1 schizophrenia-related pharmacy claim, n (%) | 3714 (100.00) | 1673 (100.00) | 2041 (100.00) | – | 1856 (100.00) | 1858 (100.00) | – |
| Number of pharmacy claims, mean (SD) | 74.61 (59.32) | 104.53 (61.87) | 50.08 (43.94) | <0.001 | 99.50 (61.58) | 49.75 (44.83) | 0<.001 |
| Number of schizophrenia-related pharmacy claims, mean (SD) | 16.43 (12.65) | 24.09 (13.41) | 10.16 (7.52) | <0.001 | 22.82 (13.15) | 10.06 (8.11) | <0.001 |
| Had ≥1 ED visit, n (%) | 3231 (87.00) | 1408 (84.16) | 1823 (89.32) | <0.001 | 1581 (85.18) | 1650 (88.81) | 0.001 |
| Had ≥1 schizophrenia-related ED visit, n (%) | 1213 (32.66) | 496 (29.65) | 717 (35.13) | <0.001 | 565 (30.44) | 648 (34.88) | 0.004 |
| Number of ED visits, mean (SD) | 5.35 (7.79) | 4.35 (6.36) | 6.16 (8.71) | <0.001 | 4.61 (6.70) | 6.08 (8.68) | <0.001 |
| Number of schizophrenia-related ED visits, mean (SD) | 0.59 (1.30) | 0.49 (1.05) | 0.68 (1.47) | <0.001 | 0.50 (1.04) | 0.68 (1.50) | <0.001 |
| Had ≥1 office visit, n (%) | 3232 (87.02) | 1531 (91.51) | 1701 (83.34) | <0.001 | 1700 (91.59) | 1532 (82.45) | <0.001 |
| Had ≥1 schizophrenia-related office visit, n (%) | 1329 (35.78) | 688 (41.12) | 641 (31.41) | <0.001 | 738 (39.76) | 591 (31.81) | <0.001 |
| Number of office visits, mean (SD) | 17.02 (28.58) | 21.95 (34.22) | 12.97 (22.14) | <0.001 | 21.18 (33.47) | 12.86 (21.89) | <0.001 |
| Number of schizophrenia-related office visits, mean (SD) | 7.81 (24.29) | 11.22 (30.68) | 5.02 (16.90) | <0.001 | 10.35 (28.67) | 5.28 (18.60) | <0.001 |
| Had ≥1 outpatient visit, n (%) | 3005 (80.91) | 1455 (86.97) | 1550 (75.94) | <0.001 | 1601 (86.26) | 1404 (75.57) | <0.001 |
| Had ≥1 schizophrenia-related outpatient visit, n (%) | 1229 (33.09) | 608 (36.34) | 621 (30.43) | 0.001 | 668 (35.99) | 561 (30.19) | <0.001 |
| Number of outpatient visits, mean (SD) | 6.21 (9.63) | 7.42 (11.55) | 5.23 (7.57) | <0.001 | 7.19 (11.20) | 5.24 (7.64) | <0.001 |
| Number of schizophrenia-related outpatient visits, mean (SD) | 1.28 (3.55) | 1.50 (4.02) | 1.09 (3.10) | <0.001 | 1.45 (3.90) | 1.11 (3.15) | 0.004 |
| Had ≥1 inpatient stay, n (%) | 3066 (82.55) | 1409 (84.22) | 1657 (81.19) | 0.015 | 1536 (82.76) | 1530 (82.35) | 0.741 |
| Had ≥1 schizophrenia-related inpatient stay, n (%) | 2040 (54.93) | 912 (54.51) | 1128 (55.27) | 0.646 | 993 (53.50) | 1047 (56.35) | 0.081 |
| Number of inpatient stays, mean (SD) | 2.42 (2.67) | 2.50 (2.86) | 2.35 (2.50) | 0.092 | 2.36 (2.73) | 2.48 (2.60) | 0.202 |
| Length of stay,d mean (SD) | 22.73 (29.12) | 24.00 (28.96) | 21.65 (29.21) | 0.026 | 20.58 (23.12) | 24.89 (33.96) | <0.001 |
| Number of schizophrenia-related inpatient stays, mean (SD) | 1.20 (1.80) | 1.25 (2.05) | 1.17 (1.57) | 0.206 | 1.18 (1.94) | 1.23 (1.65) | 0.332 |
| Schizophrenia-related length of stay,d mean (SD) | 19.83 (26.73) | 20.92 (25.25) | 18.95 (27.85) | 0.098 | 18.15 (19.88) | 21.43 (31.82) | 0.006 |
| Had ≥1 ancillary encounter, n (%) | 3621 (97.50) | 1647 (98.45) | 1974 (96.72) | <0.001 | 1818 (97.95) | 1803 (97.04) | 0.075 |
| Had ≥1 schizophrenia-related ancillary encounter, n (%) | 2769 (74.56) | 1310 (78.30) | 1459 (71.48) | <0.001 | 1439 (77.53) | 1330 (71.58) | <0.001 |
| Number of ancillary encounters, mean (SD) | 47.53 (56.10) | 63.95 (67.29) | 34.07 (40.18) | <0.001 | 59.91 (64.53) | 35.17 (42.74) | <0.001 |
| Number of schizophrenia-related ancillary encounters, mean (SD) | 28.23 (49.03) | 38.63 (19.71) | 60.01 (35.52) | <0.001 | 36.29 (57.33) | 20.18 (37.33) | <0.001 |
a
Psychiatric-related relapse event rates and all-cause and schizophrenia-related healthcare utilization compared among patients adherent (MPR ≥ 80%) and non-adherent (MPR < 80%) and persistent (continuous use defined as no refill gap or refill gap of ≤60 days for SGOA medication) and non-persistent (refill gap for SGOA medication > 60 days or SGOA discontinuation) with SGOAs.
b
Psychiatric-related relapse event defined as an inpatient admission or ED visit related to psychiatric conditions and measured during the 12-month postindex period after the first observed SGOA use.
c
P values based on Student's t test for continuous variables and chi-squared or Fisher test for categorical variables.
d
Length of stay calculated only among patients with ≥1 hospitalization.
ED, emergency department; MPR, medication possession ratio; SD, standard deviation; SGOA, second-generation oral antipsychotic.