Clin Psychopharmacol Neurosci.
2023 Aug;21(3):544-558. 10.9758/cpn.22.1017.
Treatment Retention Rates of 3-monthly Paliperidone Palmitate and Risk Factors Associated with Discontinuation: A Population-based Cohort Study
- Affiliations
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- 1Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu Country, Taiwan
- 2Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- 3College of Medicine, Chang Gung University, Taoyuan, Taiwan
- 4Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- 5Medical Affairs, Janssen Pharmaceuticals, Taipei, Taiwan
- 6Medical Affairs, Janssen Pharmaceuticals, Tokyo, Japan
- 7Global Real World Evidence, Janssen Pharmaceuticals, Titusville, NJ, USA
- 8Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 9Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 10Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
- 11School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
- KMID: 2545814
- DOI: http://doi.org/10.9758/cpn.22.1017
Abstract
Objective
Limited evidence exists regarding real-world 3-monthly paliperidone palmitate (PP3M) treatment retention and associated factors.
Methods
We conducted a retrospective, nationwide cohort study using the Taiwan National Health Insurance Research Database between October 2017 and December 2019. Adult patients with schizophrenia initiated on PP3M were enrolled. The primary outcomes were time to PP3M discontinuation, time to psychiatric hospitalization, and the proportions of patients receiving the next PP3M dose within 120 days among first-, second-, and third-dose completers. Key covariates included prior PP1M duration and adequate PP3M initiation.
Results
The PP3M treatment retention rates were 79.7%, 66.3%, and 52.5% after 6, 12, and 24 months, respectively, with 86.4%, 90.6%, and 90.0% of respective first-, second-, and third-dose completers receiving the next PP3M dose. Adequate PP3M initiation and prior PP1M treatment duration ＞ 180 days were associated with favorable PP3M treatment retention. In multivariate analyses, PP1M durations of 180−360 days (adjusted relative risk [aRR], 1.76) or ＜ 180 days (aRR, 2.79) were associated with PP3M discontinuation at the second dose. Inadequate PP3M initiation was associated with discontinuation at the third dose (aRR, 2.18). Patients fully adherent to PP3M treatment in the first year had a higher probability of being free from psychiatric hospitalization (86.7% at 2 years), compared with those partially adherent or non-adherent to PP3M in the first year.
Conclusion
Prior PP1M duration and adequate PP3M initiation are major factors affecting PP3M treatment retention. Higher PP3M treatment retention is associated with a lower risk of psychiatric hospitalization.
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