Journal Article

Factors associated with first- versus second-generation long-acting antipsychotics prescribed under ordinary clinical practice in Italy

Barbui, Corrado, Ostuzzi, Giovanni, Mazzi, Maria Angela, Ruggeri, Mirella, Nosé, Michela, Bertolini, Federico, Terlizzi, Samira, Carrà, Giuseppe, Piccinelli, Marco Piero, Turrini, Giulia, Papola, Davide, Piccoli, Alberto, Callegari, Camilla, Purgato, Marianna, Tabacchi, Tommaso, Lucii, Claudio, Gastaldon, Chiara, Magliocco, Fabio, D’Agostino, Armando, Aguglia, Andrea, Corbo, Mariangela, Bartoli, Francesco, Bortolaso, Paola, Ostinelli, Edoardo Giuseppe, Martinotti, Giovanni, Caroleo, Mariarita

2018

Overview

For many years, long-acting intramuscular (LAI) antipsychotics have been prescribed predominantly to chronic and severe patients, as a last resort when other treatments failed. Recently, a broader and earlier use of LAIs, particularly second-generation LAIs, has been emphasized. To date, few studies attempted to frame how this change in prescribing took place in real-world practice. Therefore, this study aimed to describe the clinical features of patients prescribed with LAIs, and to explore possible prescribing differences between first- and second-generations LAIs under ordinary clinical practice in Italy. The STAR Network \"Depot\" Study is an observational, longitudinal, multicenter study involving 35 centers in Italy. In the cross-sectional phase, patients prescribed with LAIs were consecutively recruited and assessed over a period of 12 months. Descriptive statistics and multivariable logistic regression analyses were employed. Of the 451 recruited patients, 61% were males. The level of social and working functioning was heterogeneous, as was the severity of disease. Seventy-two per cent of the patients had a diagnosis of the schizophrenia spectrum. Seventy per cent were prescribed with second-generation antipsychotic (SGA) LAIs (mostly paliperidone, aripiprazole and risperidone). Compared to first-generation antipsychotic (FGA) LAIs, patients prescribed with SGA LAIs were more often younger; employed; with a diagnosis of the schizophrenia spectrum or bipolar disorder; with higher levels of affective symptoms; with fewer LAI prescriptions in the past. LAIs' prescribing practices appear to be more flexible as compared to the past, although this change is mostly restricted to SGA LAIs.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Analysis / Antipsychotic agents / Antipsychotics / Aripiprazole / Bipolar disorder / Comorbidity / Complications and side effects / Diagnosis / Drug therapy / Drug use / Health aspects / Health sciences / Hospitals / Males / Maternal & child health / Medicine and Health Sciences / Mental disorders / Mental health / Metabolism / Neurosciences / Patient compliance / Patients / People and places / Physical Sciences / Prognosis / Psychiatry / Psychotic disorders / Psychotropic drugs / Regression analysis / Research and Analysis Methods / Risk factors / Risperidone / Schizophrenia / Social Sciences / Statistical analysis / Substance abuse treatment / Suicide / Surgery / Systematic review