Time to rehospitalization in involuntarily hospitalized individuals suffering from schizophrenia discharged on long-acting injectable antipsychotics or oral antipsychotics

Abstract

Background: Involuntarily hospitalized individuals suffering from schizophrenia often have a poorer prognosis after discharge. Objective: This study aimed to analyze time to rehospitalization within 6 months of discharge in involuntarily hospitalized individuals suffering from schizophrenia discharged on long-acting injectable antipsychotics (LAIs) or oral antipsychotics (OAPs). In addition, temporal trends in LAI use at discharge were explored. Methods: Involuntarily hospitalized individuals suffering from schizophrenia discharged from the study hospital between 2006 and 2019 ( n = 806) were included in the analysis. Survival analysis was used to compare time to rehospitalization within 6 months of discharge between individuals discharged on LAIs and OAPs, and between first-generation antipsychotic (FGA) LAIs and second-generation antipsychotic (SGA) LAIs. The Cochran–Armitage trend test was used to test whether a temporal trend existed for LAIs use at discharge during the study period. Results: The LAIs group ( n = 231) had a significantly lower rate of rehospitalization and a significantly longer time to rehospitalization than the OAPs group ( n = 575). Rehospitalization rate and time to rehospitalization were not significantly different between individuals discharged on FGA-LAIs and SGA-LAIs. LAIs use at discharge grew significantly from 16.77% in 2006 to 50.00% in 2019 ( Z = 6.81, p < 0.0001 ). Among all LAIs, only use of SGA-LAIs at discharge increased significantly ( Z = 5.74, p < 0.0001 ), but not FGA-LAIs. Conclusions: LAIs were superior to OAPs in preventing rehospitalization. However, SGA-LAIs were comparable with FGA-LAIs in reducing rehospitalization risk. Use of LAIs increased significantly in discharged involuntarily hospitalized individuals during the study period, especially SGA-LAIs.