Comparison of short-acting intramuscular antipsychotic medication: impact on length of stay and cost.
Adult; Female; Male; Prospective Studies; Health Care Costs; Injections; Middle Age; Retrospective Design; Intramuscular; Antiinfective Agents; Length of Stay – Statistics and Numerical Data; Schizophrenia – Drug Therapy; Heterocyclic Compounds – Therapeutic Use; Antianxiety Agents; Antipsychotic Agents – Administration and Dosage; Antipsychotic Agents – Economics; Antipsychotic Agents – Therapeutic Use; Benzodiazepine – Economics; Benzodiazepine – Therapeutic Use; Haloperidol – Economics; Haloperidol – Therapeutic Use; Heterocyclic Compounds – Economics; Length of Stay – Economics; Psychomotor Agitation – Drug Therapy; Quinolone – Economics; Quinolone – Therapeutic Use; Thiazoles – Economics; Thiazoles – Therapeutic Use
A retrospective cohort study was conducted to determine if there is an association between short-acting intramuscular (SAIM) antipsychotics used for acute agitation and length of stay (LOS). Patients with a diagnosis of schizophrenia or schizoaffective disorder who were dispensed at least one dose of a SAIM antipsychotic were divided into groups based on the initial SAIM antipsychotic received once admitted to a psychiatric unit. Electronic records were used to gather demographic information, LOS, and number of injections received during an admission. Cost was calculated from the number of injections received. One-hundred and thirty-six patients were enrolled. When comparing the haloperidol group to the second generation antipsychotic group, there was no statistically significant difference, in LOS 16.98 ± 9.56 days versus 17.59 ± 11.52 days (P = 0.75), respectively. There was a statistically significant difference in both cost and number of injections between groups, favoring the haloperidol group. Ziprasidone was associated with a shorter LOS compared with olanzapine, 13.57 and 19.10 days, respectively (P = 0.026). Patient characteristics should be evaluated when determining an agent for acute agitation. However, because literature indicates second generation SAIM antipsychotics are only noninferior to haloperidol; other factors should also be evaluated; including impact on LOS and impact on hospital resources. This study indicates use of a second generation SAIM antipsychotic for acute agitation is more costly, requires more injections, and was not associated with a shorter length of stay when compared with SAIM haloperidol.
Leung JG; Benedetti AM; Frazee L A; Myers N; Leung Jonathan G; Benedetti Amanda M; Frazee Lawrence A; Myers Nancy
American Journal of Therapeutics
2011
2011-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/MJT.0b013e3181d48320" target="_blank" rel="noreferrer noopener">10.1097/MJT.0b013e3181d48320</a>
Report on ISCTM Consensus Meeting on Clinical Assessment of Response to Treatment of Cognitive Impairment in Schizophrenia.
*Schizophrenic Psychology; Antipsychotic Agents/*therapeutic use; Cognition Disorders; Cognition Disorders/diagnosis/psychology/*therapy; cognitive assessment; Functional Assessment; Humans; Interviews; Neuropsychological Tests; neuropsychology; Nootropic Agents/*therapeutic use; Patient Selection; Psychiatric Rehabilitation/*methods; Research Instruments; Schizophrenia; Schizophrenia – Drug Therapy; Schizophrenia/diagnosis/*therapy; Severity of Illness Index; Surveys; treatment; United States Food and Drug Administration
If treatments for cognitive impairment are to be utilized successfully, clinicians must be able to determine whether they are effective and which patients should receive them. In order to develop consensus on these issues, the International Society for CNS Clinical Trials and Methodology (ISCTM) held a meeting of experts on March 20, 2014, in Washington, DC. Consensus was reached on several important issues. Cognitive impairment and functional disability were viewed as equally important treatment targets. The group supported the notion that sufficient data are not available to exclude patients from available treatments on the basis of age, severity of cognitive impairment, severity of positive symptoms, or the potential to benefit functionally from treatment. The group reached consensus that cognitive remediation is likely to provide substantial benefits in combination with procognitive medications, although a substantial minority believed that medications can be administered without nonpharmacological therapy. There was little consensus on the best methods for assessing cognitive change in clinical practice. Some participants supported the view that performance-based measures are essential for measurement of cognitive change; others pointed to their cost and time requirements as evidence of impracticality. Interview-based measures of cognitive and functional change were viewed as more practical, but lacking validity without informant involvement or frequent contact from clinicians. The lack of consensus on assessment methods was viewed as attributable to differences in experience and education among key stakeholders and significant gaps in available empirical data. Research on the reliability, validity, sensitivity, and practicality of competing methods will facilitate consensus.
Keefe Richard S E; Haig George M; Marder Stephen R; Harvey Philip D; Dunayevich Eduardo; Medalia Alice; Davidson Michael; Lombardo Ilise; Bowie Christopher R; Buchanan Robert W; Bugarski-Kirola Dragana; Carpenter William T; Csernansky John T; Dago Pedro L; Durand Dante M; Frese Frederick J; Goff Donald C; Gold James M; Hooker Christine I; Kopelowicz Alex; Loebel Antony; McGurk Susan R; Opler Lewis A; Pinkham Amy E; Stern Robert G
Schizophrenia bulletin
2016
2016-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/schbul/sbv111" target="_blank" rel="noreferrer noopener">10.1093/schbul/sbv111</a>