Poster
91
(#91) Antipsychotic Medication Utilization and Treatment Patterns Among Patients With Schizophrenia: A Real-World Evidence Study
Psych Congress 2025
Abstract: Rationale: This study assessed treatment patterns and adherence among patients with a diagnosis of schizophrenia receiving antipsychotic medications.
Methods: 100% Medicare Fee-for-Service (1/1/2016-12/31/2022) and MORE2 Registry® (1/1/2016-9/30/2023) claims databases were analyzed retrospectively. Inclusion criteria were ≥1 inpatient or ≥2 outpatient claims with a schizophrenia diagnosis, ≥2 claims for an antipsychotic (earliest claim=index date), aged ≥18 years on index date, continuous enrollment ≥6 months before and ≥12 months post index, and no antipsychotic claims during the 6-month pre-index period. Subgroup analyses were based on route of administration (oral antipsychotic [OAP] versus long-acting injectable [LAI]) and evidence of comorbid hypertension. The primary endpoint was class-level medication adherence (proportion of days covered ≥0.80 during follow-up). Additional endpoints included antipsychotic switching/augmentation and antihypertensive adherence in patients with hypertension.
Results: Among 212,770 patients, mean age [±SD] was 46.3±16.3 years and 54.9% were male. The most common index antipsychotics were risperidone (21.1%), quetiapine (19.8%), and olanzapine (19.2%). Most patients received OAPs only (82.3%), and 15.9% received LAI-containing regimens. Adherence was low for both (39.6% and 50.2%, respectively), with greatest adherence among clozapine initiators (67.8%). Treatment switching/augmentation was observed among 9.3%/4.8% of patients, respectively, and was ≈2-fold more frequent with LAI-containing regimens versus OAPs. Among patients with hypertension (23.1%), adherence to antipsychotics and antihypertensives was 47.4% and 66.1%, respectively.
Conclusions: Antipsychotic adherence remains suboptimal among US patients with schizophrenia. In this study, it remained low among patients adherent to oral antihypertensives, suggesting selective nonadherence. Newer antipsychotics with better tolerability may improve adherence and clinical outcomes.
Short Description: This retrospective analysis of US claims data evaluated antipsychotic treatment patterns and adherence among more than 200,000 patients with schizophrenia. Adherence was low for both oral and long-acting injectable antipsychotics. Results highlight the need for strategies and novel therapies to improve adherence and clinical outcomes in this population.
Name of Sponsoring Organization(s): Bristol Myers Squibb
Methods: 100% Medicare Fee-for-Service (1/1/2016-12/31/2022) and MORE2 Registry® (1/1/2016-9/30/2023) claims databases were analyzed retrospectively. Inclusion criteria were ≥1 inpatient or ≥2 outpatient claims with a schizophrenia diagnosis, ≥2 claims for an antipsychotic (earliest claim=index date), aged ≥18 years on index date, continuous enrollment ≥6 months before and ≥12 months post index, and no antipsychotic claims during the 6-month pre-index period. Subgroup analyses were based on route of administration (oral antipsychotic [OAP] versus long-acting injectable [LAI]) and evidence of comorbid hypertension. The primary endpoint was class-level medication adherence (proportion of days covered ≥0.80 during follow-up). Additional endpoints included antipsychotic switching/augmentation and antihypertensive adherence in patients with hypertension.
Results: Among 212,770 patients, mean age [±SD] was 46.3±16.3 years and 54.9% were male. The most common index antipsychotics were risperidone (21.1%), quetiapine (19.8%), and olanzapine (19.2%). Most patients received OAPs only (82.3%), and 15.9% received LAI-containing regimens. Adherence was low for both (39.6% and 50.2%, respectively), with greatest adherence among clozapine initiators (67.8%). Treatment switching/augmentation was observed among 9.3%/4.8% of patients, respectively, and was ≈2-fold more frequent with LAI-containing regimens versus OAPs. Among patients with hypertension (23.1%), adherence to antipsychotics and antihypertensives was 47.4% and 66.1%, respectively.
Conclusions: Antipsychotic adherence remains suboptimal among US patients with schizophrenia. In this study, it remained low among patients adherent to oral antihypertensives, suggesting selective nonadherence. Newer antipsychotics with better tolerability may improve adherence and clinical outcomes.
Short Description: This retrospective analysis of US claims data evaluated antipsychotic treatment patterns and adherence among more than 200,000 patients with schizophrenia. Adherence was low for both oral and long-acting injectable antipsychotics. Results highlight the need for strategies and novel therapies to improve adherence and clinical outcomes in this population.
Name of Sponsoring Organization(s): Bristol Myers Squibb
