Table 2.
Demographic and clinical characteristics evaluated during the 12-month baseline period in unweighted and IPT-weighted overall cohorts
| Overall cohort | ||||||
|---|---|---|---|---|---|---|
| Unweighted | IPT-weighted | |||||
| PP1M (N = 2053) | OAA (N = 22,247) | Std. Diff. a | PP1M (N = 11,612) | OAA (N = 12,688) | Std. Diff. a | |
| Age at index date (years), mean ± SD [median] | 41.3 ± 12.6 [41.5] | 43.9 ± 13.5 [45.0] | 19.8% | 42.9 ± 12.9 [43.6] | 43.6 ± 13.4 [44.7] | 5.1% |
| Female, % | 39.2% | 50.8% | 23.6% | 46.4% | 49.6% | 6.6% |
| Race, % | ||||||
| White | 49.5% | 58.0% | 17.0% | 56.2% | 57.1% | 1.9% |
| Black | 41.6% | 33.1% | 17.5% | 34.2% | 33.9% | 0.6% |
| Hispanic | 0.1% | 0.2% | 1.7% | 0.3% | 0.2% | 1.7% |
| Other | 6.1% | 6.1% | 0.1% | 6.5% | 6.1% | 1.4% |
| Unknown | 2.6% | 2.6% | 0.4% | 2.8% | 2.6% | 1.5% |
| State, % | ||||||
| Iowa | 4.7% | 6.6% | 8.2% | 7.2% | 6.4% | 3.2% |
| Kansas | 10.2% | 7.6% | 9.1% | 8.1% | 7.9% | 0.8% |
| Mississippi | 12.3% | 10.0% | 7.4% | 8.8% | 10.2% | 4.7% |
| Missouri | 50.4% | 50.4% | 0.1% | 52.4% | 50.4% | 3.9% |
| New Jersey | 22.4% | 25.4% | 7.2% | 23.5% | 25.1% | 3.7% |
| Region characteristics, % | ||||||
| Urban | 55.4% | 56.2% | 1.5% | 55.4% | 56.1% | 1.4% |
| Suburban | 26.7% | 26.3% | 1.0% | 25.8% | 26.2% | 0.9% |
| Rural | 17.9% | 17.5% | 0.9% | 18.7% | 17.7% | 2.8% |
| Insurance eligibility, % | ||||||
| Capitated or dual coverage | 66.1% | 66.7% | 1.1% | 67.1% | 66.6% | 1.2% |
| Capitated | 40.4% | 41.5% | 2.1% | 41.9% | 41.5% | 1.0% |
| Dual coverage | 39.6% | 39.9% | 0.5% | 40.4% | 39.8% | 1.3% |
| Year of index date, % | ||||||
| 2009 | 14.3% | 12.4% | 5.4% | 9.9% | 12.5% | 8.3% |
| 2010 | 38.6% | 37.1% | 3.2% | 34.1% | 37.2% | 6.3% |
| 2011 | 21.0% | 23.8% | 6.6% | 21.7% | 23.5% | 4.3% |
| 2012 | 13.1% | 14.5% | 4.1% | 17.7% | 14.4% | 9.0% |
| 2013 | 10.3% | 9.5% | 2.5% | 13.0% | 9.7% | 10.4% |
| 2014 | 2.7% | 2.7% | 0.4% | 3.5% | 2.7% | 4.8% |
| Quan-CCI, mean ± SD [median] | 0.7 ± 1.3 [0.0] | 1.1 ± 1.7 [1.0] | 26.7% | 1.0 ± 1.6 [1.0] | 1.1 ± 1.7 [1.0] | 5.4% |
| Number of unique mental health diagnoses, mean ± SD [median] | 7.2 ± 7.0 [5.0] | 8.4 ± 8.5 [6.0] | 15.0% | 8.7 ± 8.1 [6.0] | 8.3 ± 8.4 [6.0] | 4.6% |
| Number of unique AP agents received, mean ± SD [median] | 1.7 ± 1.1 [2.0] | 1.0 ± 1.1 [1.0] | 65.5% | 1.3 ± 1.2 [1.0] | 1.1 ± 1.1 [1.0] | 17.7% |
| AP use, % | 87.8% | 61.8% | 62.8% | 67.9% | 64.2% | 8.0% |
| Typical oral and short-term injectable | 24.2% | 22.4% | 4.2% | 27.0% | 22.8% | 9.9% |
| Atypical oral and short-term injectable | 65.7% | 49.6% | 33.0% | 54.9% | 51.0% | 7.7% |
| Typical LAI | 17.4% | 6.0% | 36.2% | 8.5% | 7.2% | 4.9% |
| Atypical LAI | 36.7% | 5.3% | 83.4% | 9.1% | 8.3% | 2.8% |
| Proportion of days covered (PDC) by any AP agent, % | ||||||
| PDC < 0.8b | 64.3% | 67.2% | 6.2% | 67.2% | 66.9% | 0.7% |
| PDC ≥ 0.8b | 35.7% | 32.8% | 6.2% | 32.8% | 33.1% | 0.7% |
| AP polypharmacy presentc, % | 22.9% | 10.9% | 32.6% | 14.4% | 12.1% | 7.0% |
| Other psychiatric medication use, % | 71.7% | 76.8% | 11.6% | 75.2% | 76.6% | 3.1% |
| Antidepressants | 50.1% | 57.0% | 13.9% | 55.4% | 56.4% | 2.1% |
| Anxiolytics | 40.1% | 50.3% | 20.6% | 50.0% | 49.4% | 1.1% |
| Mood stabilizers | 40.3% | 41.0% | 1.5% | 42.9% | 41.1% | 3.6% |
| Number of unique psychiatric agents receivedd, mean ± SD [median] | 3.6 ± 2.4 [3.0] | 3.3 ± 2.6 [3.0] | 11.3% | 3.4 ± 2.7 [3.0] | 3.3 ± 2.6 [3.0] | 4.6% |
| Psychiatric polypharmacy presente, % | 44.5% | 37.2% | 14.9% | 39.6% | 38.1% | 3.0% |
| Specific comorbidities presentf, % | ||||||
| Cardiovascular diseaseg | 11.2% | 18.3% | 20.1% | 15.6% | 17.6% | 5.6% |
| Diabetes | 20.5% | 24.0% | 8.6% | 23.1% | 23.7% | 1.5% |
| Obesity | 9.4% | 10.4% | 3.3% | 12.9% | 10.4% | 7.9% |
| Drug abuse | 21.5% | 19.9% | 4.0% | 21.2% | 20.1% | 2.8% |
| Hepatitis Cg | 3.4% | 4.7% | 6.6% | 4.2% | 4.5% | 1.6% |
| HIV/AIDS | 1.3% | 1.8% | 4.3% | 2.1% | 1.8% | 2.3% |
| Baseline monthly healthcare costs (2015 $US), mean ± SD [median] | ||||||
| Total healthcare costs | $2050 ± $2848 [$1288] | $2230 ± $3883 [$1125] | 5.3% | $2091 ± $3162 [$1098] | $2226 ± $3818 [$1154] | 3.9% |
| Total pharmacy costs | $510 ± $762 [$107] | $363 ± $677 [$54] | 20.4% | $420 ± $746 [$47] | $372 ± $678 [$57] | 6.7% |
| Total medical costs | $1540 ± $2581 [$843] | $1867 ± $3727 [$783] | 10.2% | $1671 ± $2855 [$777] | $1854 ± $3661 [$802] | 5.6% |
| Baseline healthcare resource utilization, % with ≥1 visit/service | ||||||
| Outpatient visits | 91.1% | 91.7% | 2.2% | 92.4% | 91.7% | 2.6% |
| Number of visits per month, mean ± SD [median] | 1.06 ± 1.54 [0.67] | 1.33 ± 2.25 [0.83] | 13.6% | 1.22 ± 2.04 [0.75] | 1.31 ± 2.22 [0.75] | 4.3% |
| Emergency room visits | 48.4% | 56.5% | 16.2% | 53.5% | 56.0% | 5.1% |
| Number of visits per month, mean ± SD [median] | 0.16 ± 0.49 [0.00] | 0.20 ± 0.56 [0.08] | 7.4% | 0.19 ± 0.51 [0.08] | 0.20 ± 0.56 [0.08] | 2.1% |
| Inpatient visits | 46.7% | 54.2% | 15.2% | 55.9% | 53.9% | 3.9% |
| Number of visits per month, mean ± SD [median] | 0.11 ± 0.28 [0.00] | 0.13 ± 0.26 [0.08] | 7.7% | 0.13 ± 0.25 [0.08] | 0.13 ± 0.26 [0.08] | 0.4% |
| Long-term care admissions | 4.6% | 8.3% | 15.0% | 6.9% | 8.1% | 4.7% |
| Number of admissions per month, mean ± SD [median] | 0.01 ± 0.04 [0.00] | 0.02 ± 0.10 [0.00] | 12.6% | 0.01 ± 0.05 [0.00] | 0.02 ± 0.10 [0.00] | 8.3% |
| Mental health institute admissions | 62.6% | 39.5% | 47.4% | 51.4% | 41.3% | 20.5% |
| Number of admissions per month, mean ± SD [median] | 0.73 ± 1.18 [0.17] | 0.36 ± 0.86 [0.00] | 35.5% | 0.45 ± 0.91 [0.08] | 0.40 ± 0.90 [0.00] | 5.5% |
| One-day mental health institute admissions | 72.0% | 53.2% | 39.6% | 61.1% | 54.6% | 13.1% |
| Number of admissions per month, mean ± SD [median] | 1.28 ± 1.47 [0.75] | 0.70 ± 1.16 [0.08] | 43.7% | 0.81 ± 1.18 [0.25] | 0.76 ± 1.21 [0.08] | 4.0% |
| Home care | 33.9% | 37.0% | 6.4% | 35.8% | 36.9% | 2.2% |
| Number of services per month, mean ± SD [median] | 0.76 ± 2.73 [0.00] | 1.10 ± 3.92 [0.00] | 10.2% | 0.85 ± 3.19 [0.00] | 1.09 ± 3.88 [0.00] | 6.9% |
| Other services | 34.3% | 33.5% | 1.8% | 32.2% | 33.3% | 2.3% |
| Number of services per month, mean ± SD [median] | 0.12 ± 0.32 [0.00] | 0.13 ± 0.41 [0.00] | 3.8% | 0.11 ± 0.29 [0.00] | 0.13 ± 0.41 [0.00] | 6.4% |
AP antipsychotics, CCI Charlson comorbidity index, IPT inverse probability of treatment, LAI long-acting injectable therapy, OAA oral atypical antipsychotics, PDC proportion of days covered, PP1M once-monthly paliperidone palmitate
aBaseline characteristics with a standardized difference <10% were considered well balanced. For continuous variables, the standardized difference is calculated by dividing the absolute difference in means of the PP1M and the OAA cohorts by the pooled standard deviation of both groups. The pooled standard deviation is the square root of the average of the squared standard deviations. For categorical variables with 2 levels, the standardized difference is calculated using the following equation where P is the respective proportion of participants in each group: (PPP1M-POAA)/√[p(1-p)], where p = (PPP1M + POAA)/2
bThe denominator for the proportion of patients with a PDC <0.8 or a PDC ≥0.8 is the number of patients with a PDC >0
cAP polypharmacy is defined as having overlapping coverage of ≥2 unique AP agents for at least 60 consecutive days with no gaps larger than 7 days
dIncludes: mood stabilizers, anxiolytics, antidepressants, and antipsychotics
ePsychiatric polypharmacy is defined as having overlapping coverage of ≥1 AP agent and ≥1 anxiolytic, antidepressant, or mood stabilizer for at least 60 consecutive days with no gaps larger than 7 days.
fReference: Elixhauser A, Steiner C, Kruzikas. D. HCUP Methods Series Report # 2004–1. ONLINE February 6, 2004. U.S. Agency for Healthcare Research and Quality. [Internet]. Comorbidity Software Documentation. Rockville, MD, USA; 2004 [cited 2013]. p. 12–5. Available from: http://www.hcup-us.ahrq.gov/reports/ComorbiditySoftwareDocumentationFinal.pdf
gCardiovascular disease was defined using ICD-9-CM codes: 410.xx, 411.0×, 411.81, 411.89, 411.1×, 413.xx, 427.5×, 427.1×, 427.4×, 427.3×, 398.91, 428.xx, 414.0×, 414.1×, 414.8×, 414.9×, 429.3×, 402.9×, 430.xx, 431.xx, 432.xx, 433.xx, 434.xx, 435.xx, 436.xx, 437.xx, 427.89; hepatitis C were defined using the ICD-9 codes: 070.41, 070.44, 070.51, 070.54, 070.7×, V02.62