摘要
【ABSTRACT】【Objective】The primary objective of this study was to assess the prescribing patterns of long acting injectable (LAI) antipsychotics in an older adult population. Secondary objectives were to determine if there were differences in treatment discontinuation rates between different LAI agents and race/ethnicity.【Methods】Merative MarketScan Multi‐State Medicaid Databases (2017–2021) were used to identify patients 65 years or older who were prescribed a LAI antipsychotic. Pharmacy claims for LAI antipsychotics were referenced via National Drug Code (NDC) by brand/generic name and dose. International Classification of Diseases, 10th edition (ICD‐10) codes were used to identify older adults diagnosed with schizophrenia, schizotypal or schizoaffective disorders. Those with dementia or related disorders were censored. Conditional associations between race/ethnicity and generation of LAI antipsychotics were investigated using logistic regression controlling for age, sex, and health plan. Cox proportional hazard regression was used to compare the distribution of time until treatment discontinuation among older adults across LAI antipsychotics.【Results】A total of 526 older adults (59% female) with an average age of 70.4 ± 5.5 years met inclusion for analysis. The most commonly used LAI antipsychotics included paliperidone palmitate‐1 month formulation (~35%), haloperidol decanoate (~24%), and risperidone microspheres (~15%). Overall, approximately 32% received LAI first‐generation antipsychotics and 68% received LAI second generation antipsychotics. Blacks (n = 204) received LAI first‐generation antipsychotics more often than Whites (n = 283); (OR: 1.74, 95% [1.18, 2.56], p < 0.01). When controlling for age, sex, and race/ethnicity, LAI first‐generation antipsychotics showed earlier discontinuation rates compared to LAI second‐generation antipsychotics (HR: 2.12, 95% CI [1.45, 3.10], p < 0.001).【Conclusions】LAI first‐generation antipsychotics showed treatment discontinuation significantly earlier compared to LAI second‐generation antipsychotics. Furthermore, Blacks were prescribed LAI first‐generation antipsychotics at a higher rate than Whites, which may contribute to poorer health outcomes. Futures studies are needed to establish a causal relationship.
摘要译文
【摘要】【目的】目的】本研究的主要目的是评估老年人人口中长作用（LAI）抗精神病药的处方模式。次要目标是确定不同LAI代理和种族/种族之间的治疗停止率是否存在差异。方法】方法】MerativeMarketScan多国医疗补助数据库（2017-2021）被用来识别65岁或以上的患者。通过品牌/通用名称和剂量，通过国家毒品法典（NDC）引用了对LAI抗精神病药的药学索赔。国际疾病分类，第10版（ICD -10）代码用于识别被诊断为精神分裂症，精神分裂症或精神分裂性疾病的老年人。患有痴呆症或相关疾病的人受到审查。使用对年龄，性别和健康计划的逻辑回归控制，研究了种族/种族与LAI抗精神病药之间的有条件关联。使用COX比例危害回归来比较在LAI抗精神病药中老年人中停用的时间的分布。结果总共有526名老年人（59％女性），平均年龄为70.4±5。5年。最常用的LAI抗精神病药包括棕榈酸棕榈酸酯1个月的配方（〜35％），氟哌啶醇decanoate（〜24％）和利培酮微球（〜15％）。总体而言，大约32％的人接受了LAI第一代抗精神病药，而68％的人接受了LAI第二代抗精神病药。黑人（n = 204）比白人更频繁地接受LAI第一代抗精神病药（n = 283）；（OR：1.74，95％[1.18，2.56]，p <0.01）。在控制年龄，性别和种族/种族/种族/种族/种族/种族时，LAI第一代抗精神病药与LAI第二代抗精神病药（HR：2.12，95％CI [1.45，3.10]相比，较早的中断率与较早的抗毒剂相比，p <0.001）。抗精神病药。此外，黑人被开处方的LAI第一代抗精神病药的速度要比白人高，这可能导致健康结果较差。需要期货研究以建立因果关系。
Christopher M. Cassara (https://orcid.org/0009-0009-0574-1215) [1];Jianing Xu (https://orcid.org/0000-0002-3891-8867) [2];Daniel B. Hall (https://orcid.org/0000-0003-2543-2400) [3];Xianyan Chen (https://orcid.org/0000-0002-1806-0883) [4];Henry N. Young (https://orcid.org/0000-0002-4803-3288) [5];Joshua Caballero (https://orcid.org/0000-0003-4406-2425) [6];. Use and Discontinuation Rates of Long‐Acting Injectable Antipsychotics Between Race/Ethnicity in Older Adults Using Medicaid Databases[J]. Journal of the American Geriatrics Society, 2025,73(5): 1454-1461