Short-term rehospitalizations in young adults with schizophrenia treated with once-monthly paliperidone palmitate or oral atypical antipsychotics: a retrospective analysis

<b>Objective:</b> To compare rehospitalizations in patients with schizophrenia treated with paliperidone palmitate (PP1M) versus oral atypical antipsychotics (OAAs) with a focus on young adults (18-35 years). <b>Methods:</b> The Premier Healthcare database (01/2009-12/2016) was used to identify hospitalizations of adults (≥18 years) with schizophrenia treated with PP1M or OAA between 09/2009 and 10/2016 (index hospitalizations). Rehospitalizations were assessed at 30, 60, and 90 days after each index hospitalization in young adults and in all patients. Proportions of index hospitalizations resulting in rehospitalization were reported and compared between groups using odds ratios (ORs) and 95% confidence intervals (CIs). <b>Results:</b> A total of 8,578 PP1M and 306,252 OAA index hospitalizations were included. Hospitalized young adults treated with PP1M (N = 3,791) were more likely to be seen by a psychiatrist (94.0% vs. 90.0%), and had a longer length of stay (12.5 vs. 8.6 days) compared to hospitalized young adults treated with OAA (N = 96,502). Following their discharge, young adults receiving PP1M during an index hospitalization had a 25% to 27% lower odds of rehospitalization within 30, 60, and 90 days compared to young adults receiving OAAs (all <i>P</i>&lt;0.001). Similarly, when observing all patients, those receiving PP1M during an index hospitalization had 19% to 22% lower odds of rehospitalization within 30, 60, and 90 days compared to those receiving OAAs (all <i>P</i>&lt;0.001). <b>Conclusions:</b> Following a hospitalization for schizophrenia, PP1M treatment was associated with fewer 90-day rehospitalizations among young adults (18-35 years) relative to OAA treatment. This finding was also observed in other hospitalized adults with schizophrenia.

**研究目的：** 比较接受棕榈酸帕利哌酮（paliperidone palmitate，PP1M）与口服非典型抗精神病药（oral atypical antipsychotics，OAAs）治疗的精神分裂症患者的再住院情况，重点关注青年成人（18~35岁）队列。
**研究方法：** 本研究使用Premier医疗数据库（2009年1月-2016年12月），在2009年9月至2016年10月期间筛选≥18岁的精神分裂症成人住院患者，这些患者均接受PP1M或OAAs治疗（即索引住院病例）。分别针对青年成人队列及全体患者，评估每例索引住院后30、60、90天内的再住院发生情况。报告各组因索引住院导致再住院的比例，并采用比值比（odds ratios，ORs）及95%置信区间（confidence intervals，CIs）进行组间比较。
**研究结果：** 最终纳入8578例PP1M组索引住院病例及306252例OAAs组索引住院病例。与接受OAAs治疗的住院青年成人（N=96502）相比，接受PP1M治疗的住院青年成人（N=3791）更常接受精神科医师诊疗（94.0% vs 90.0%），且住院时长更长（12.5天 vs 8.6天）。出院后，与接受OAAs治疗的青年成人相比，索引住院期间接受PP1M治疗的青年成人在30、60、90天内再住院的比值比降低25%~27%（所有*P*<0.001）。类似地，在全体患者队列中，索引住院期间接受PP1M治疗者的30、60、90天内再住院比值比较OAAs组降低19%~22%（所有*P*<0.001）。
**研究结论：** 精神分裂症患者住院治疗后，与OAAs治疗相比，PP1M治疗可降低青年成人（18~35岁）90天内的再住院率。该结果在全体住院精神分裂症成人队列中同样成立。