Patient Preference and Adherence (Jun 2017)

Comparison of clinical outcomes with orodispersible versus standard oral olanzapine tablets in nonadherent patients with schizophrenia or bipolar disorder

  • Novick D,
  • Montgomery W,
  • Treuer T,
  • Koyanagi A,
  • Aguado J,
  • Kraemer S,
  • Haro JM

Journal volume & issue
Vol. Volume 11
pp. 1019 – 1025

Abstract

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Diego Novick,1 William Montgomery,2 Tamas Treuer,3 Ai Koyanagi,4 Jaume Aguado,4 Susanne Kraemer,5 Josep Maria Haro4 1Global Patient Outcomes and Real World Evidence (GPORWE), Eli Lilly and Company, Windlesham, Surrey, UK; 2Global Patient Outcomes and Real World Evidence (GPORWE), Eli Lilly Australia Pty Ltd, West Ryde, Australia; 3Global Patient Outcomes and Real World Evidence (GPORWE), Eli Lilly and Company, Budapest, Hungary; 4Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; 5Medical Department, Eli Lilly and Company, Bad Homburg, Germany Purpose: Medication nonadherence is common in the treatment of patients with severe mental illness and is a frequent cause of relapse. Different formulations have been developed in an effort to improve medication adherence. The aim of this study was to explore whether there are differential clinical outcomes between two different formulations of olanzapine (orodispersible tablets [ODTs] vs standard oral tablets [SOT]) for the treatment of nonadherent patients with schizophrenia or bipolar disorder.Methods: Data for this analysis were from an observational study conducted in Europe (N=903). Adult schizophrenia and bipolar disorder patients in outpatient settings who initiated or changed to either olanzapine ODT or SOT according to physician decision within the last 45 days were eligible for enrollment. The follow-up period was 1 year. Of the 903 participants, 266 nonadherent patients (Medication Adherence Rating Scale score 0–4 at baseline) were included in the analysis. Clinical outcomes of interest were: 1) hospitalization and 2) relapse identified by the participating psychiatrist or hospitalization. An adjusted logistic regression model was fitted.Results: Patients taking ODT had more severe illness at baseline (P<0.001) as assessed with the Clinical Global Impression with mean (standard deviation [SD]) scores of ODT 4.63 (1.03) and SOT 4 (1.16). In the regression models adjusted for potential confounders, patients taking ODT had significantly lower odds for hospitalization (odds ratio =0.355; 95% confidence interval =0.13–0.974) and relapse or hospitalization (odds ratio =0.368; 95% confidence interval =0.183–0.739), respectively.Conclusion: Nonadherent patients with schizophrenia or bipolar disorder treated with the orodispersible formulation were less likely to be hospitalized or suffer relapse compared to those patients taking the standard oral coated tablets. Keywords: olanzapine, schizophrenia, bipolar disorder, orodispersible formulation, relapse, hospitalization 

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