Purpose: Evaluate recovery outcomes in consumers treated with the long acting injectable paliperidone palmitate (PP).
Methods: A retrospective within-subjects comparison was conducted to evaluate recovery outcome measures before and during treatment periods. Adult PP-treated consumers with schizophrenia or schizoaffective disorder, were new to PP, had at least six-months of therapy, and were naïve to long-acting antipsychotic injections six-months prior to PP, were analyzed. The Recovery Markers Inventory (RMI) and the Consumer Recovery Measure (CRM) provide clinician and consumer perspectives, respectively. The RMI, CRM, and public service utilizations (PSU) such as jail days, hospitalization for psychiatric or physical reasons, and detoxification facilities were evaluated using a multilevel-regression model framework. Total cost savings from PSU reductions was estimated using a state perspective expressed in 2014 US dollars. No adjustment was made for multiplicity.
Results: 219 consumers were analyzed; 68% males, mean age was 41.6 years (SD=12.8), 59% had at least one concurrent medication, and average PP therapy duration was 115 weeks (SD=60.8). Significant post-treatment period increases in the RMI (b0pre=4.05, b0post=4.15; p<0.05) and CRM (b0pre=6.14, b0post=6.40, p<0.05) intercepts were found, along with significant increases on the RMI in the post-period slope (b1pre=0, b1post=0.005; p<0.05. Significant reductions were found in quarterly jail (Mdiff=-2.34; p<0.05) and psychiatric hospitalization (Mdiff=-5.18; p<0.05) days, resulting in a PSU estimated cost savings of $33,600/year/consumer.
Conclusion: Improvements in recovery and reduced public service utilization during the PP treatment period may suggest potential long-term benefits for PP-treated consumers. Comparative, prospective studies on recovery outcome measures are warranted.
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