Noninterventional, naturalistic, retrospective study to describe prescription patterns of long-acting injectable antipsychotics and the impact of introducing a new atypical antipsychotic in the spanish province of tarragona catchment area

Background: We studied the patterns and predictors of long-acting injectable (LAI) antipsychotic (AP) use in the treatment of schizophrenia and the effect of introducing a new LAI (paliperidone palmitate [paliperidone-LAI]) in the Spanish province of Tarragona. Methods: This noninterventional, naturalistic, retrospective study included electronic medical record data from a large population-based database of 1,646 patients who were diagnosed with schizophrenia according to ICD-10 criteria and treated between January 2011 and December 2013. Results: During the study period, 42.0% of patients were treated with an LAI AP. The most frequently prescribed initial LAI was risperidone (52.0% of patients). A total of 23% of patients initially treated with an oral AP were switched to an LAI AP, a change that was associated with younger age (P =.001), undifferentiated schizophrenia (P =.015), substance abuse (P <.001), and neuropsychiatric comedication with the following agents: anticonvulsants (P =.004), anticholinergics (P <.001), and hypnotics/sedatives (P =.03). The change from an oral AP to paliperidone-LAI was predicted by younger age (P <.001). Overall, 27.5% of patients switched to another LAI AP, and paliperidone-LAI was the preferred option in 64.7% of cases. The most frequent change involved patients taking risperidone-LAI, many of whom transitioned to paliperidone-LAI (85.0% of cases), particularly patients with a disease duration > 5 years (P =.019). Conclusions: There was a progressive increase in the use of LAI formulations in our catchment area. These agents were preferentially prescribed to patients with chronic disease and a history of substance abuse, as well as patients receiving neuropsychiatric comedication. One-month LAI formulations were commonly used in young patients.