Comparison of short-acting intramuscular antipsychotic medication: impact on length of stay and cost.

Comparison of short-acting intramuscular antipsychotic medication: impact on length of stay and cost.

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

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.

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

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