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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Psychiatry 1/2018

The Research and Evaluation of Antipsychotic Treatment in Community Behavioral Health Organizations, Outcomes (REACH-OUT) study: real-world clinical practice in schizophrenia

Zeitschrift:
BMC Psychiatry > Ausgabe 1/2018
Autoren:
Kruti Joshi, Lian Mao, David M. Biondi, Robert Millet
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12888-018-1594-1) contains supplementary material, which is available to authorized users.

Abstract

Background

Outpatient facilities, such as community behavioral health organizations (CBHOs), play a critical role in the care of patients with serious mental illness, but there is a paucity of “real-world” patient outcomes data from this health care setting. Therefore, we conducted The Research and Evaluation of Antipsychotic Treatment in Community Behavioral Health Organizations, Outcomes (REACH-OUT) trial, a real-world, prospective, noninterventional observational study of patients with mental illness treated at CBHOs across the United States. We describe demographic and clinical characteristics, antipsychotic therapy (APT) treatment patterns, and health care resource utilization in patients with schizophrenia undergoing medical care as usual.

Methods

This study enrolled adults with schizophrenia or bipolar I disorder who initiated APT treatment at various time points: 1) within 8 weeks of initiating risperidone long-acting injectables (RLAIs) or other APTs except paliperidone palmitate (PP), 2) after more than 24 weeks of continuous RLAI treatment, or 3) at any time after initiating PP LAI treatment (schizophrenia only). Study assessments were performed via participant interview, medical chart abstraction, and clinical survey at enrollment and at month 12.

Results

A total of 1065 patients from 46 CBHOs were enrolled. Of these, 944 (88.6%) had a diagnosis of schizophrenia and 121 (11.4%) had bipolar I disorder. At enrollment, 599 (63.5%) of patients with schizophrenia were receiving RLAIs or PP LAI, 281 (29.8%) were receiving oral APTs, and 64 (6.8%) were receiving other injectable APTs. A number of differences in patient characteristics and outcomes were observed between patients in the LAI APT cohort and the oral APT cohort.

Conclusion

Descriptive analyses from this observational study suggest differences in the patient characteristics, treatment patterns, and clinical and economic outcomes among those with schizophrenia treated at CBHOs with LAI APT or oral APTs. Additional analyses will be conducted to delineate the impact of LAI APT versus oral APTs on patient outcomes.

Trial registration

Clinical Trial Registry: NCT01181960. Registered 12 August 2010.
Zusatzmaterial
Additional file 1: Table S1. Ethics committees by study site. (DOCX 13 kb)
12888_2018_1594_MOESM1_ESM.docx
Additional file 2: Table S2. Outpatient utilization at enrollment and at the 12-month follow-up visit. (DOCX 14 kb)
12888_2018_1594_MOESM2_ESM.docx
Additional file 3: Figure S1. Mean change from baseline (enrollment) in Lehman’s Quality of Life Interview scores (12-month follow-up visit). APT, antipsychotic therapy; LAI, long-acting injectable (includes paliperidone palmitate long-acting injectable and risperidone long-acting injectable); QOLI, Quality of Life Interview. Total LAI APT = LAI new users + LAI continuous users. (EPS 2025 kb)
12888_2018_1594_MOESM3_ESM.eps
Additional file 4: Figure S2. Mean change from baseline in social engagement and patient–caregiver engagement (12-month follow-up visit). APT, antipsychotic therapy; LAI, long-acting injectable (includes paliperidone palmitate long-acting injectable and risperidone long-acting injectable); QOLI, Quality of Life Interview. Total LAI APT = LAI new users + LAI continuous users. (EPS 2044 kb)
12888_2018_1594_MOESM4_ESM.eps
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