Comparison of long-acting injectable antipsychotics with oral antipsychotics and hospital readmission rates at 3 months in pediatric patients \

Mental Health Clinician 

Authors: Danial Chowdhury, Megan Maroney, Mei Liu, Caitlin McCarthy, Daniel Greer, A. Scott Mathis 



Type: Work in Progress. Background: Long-acting injectable antipsychotics (LAIAs) were developed to improve medication adherence, and some studies indicate that using LAIAs instead of their oral counterpart reduces the risk of relapse and hospitalization. The use of oral formulations of antipsychotics is common in the pediatric population, but little is known regarding the off-label use of LAIAs in this population. Dosing recommendations for LAIAs are based on data from adult populations, and LAIA use in the pediatric population lacks long-term safety data. Objectives: (1) Compare hospital readmission rates of pediatric patients on LAIA therapy with those on oral antipsychotic therapy at 3 months. (2) Compare readmission rates at 6 and 12 months. (3) Analyze differences in chlorpromazine equivalents. Methods: This IRB-approved retrospective chart review will include pediatric patients under the age of 18 that were admitted to the psychiatric ward in a large academic hospital between January 1, 2016 and December 1, 2022, and required antipsychotic therapy. The experimental group will look at patients that were initiated on LAIA therapy during their hospital stay, and the control group will look at patients started on a new oral antipsychotic medication while admitted. Patients discharged on polypharmacy of 2 or more different antipsychotic medications and those age 18 and older will be excluded. Demographic information (age, sex, gender, race, and weight) will be collected. Other pertinent data to be collected include primary diagnosis, concurrent medications, psychiatric comorbidities, number of previous antipsychotic trials, number of previous hospitalizations, choice of antipsychotic used, number of hospital readmissions (at 3, 6, and 12 months), hospital length of stay, and chlorpromazine equivalents. Data analyses will include descriptive statistics, a propensity score matching to compare the two patient groups, and unpaired Student t test. Outcomes: We will report the readmission rate at 3 months for both the LAIA and oral antipsychotic groups. In addition, we will expand the readmission rate at 6 and 12 months for added longterm monitoring. Demographics, dose of antipsychotic chlorpromazine equivalents, hospital length of stay, proper medication administration, and side effect rates will also be reported. 

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