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Eur Psychiatry. 2018 Aug;52:85-94. doi: 10.1016/j.eurpsy.2018.04.004. Epub 2018 May 4.

Baseline results from the European non-interventional Antipsychotic Long acTing injection in schizOphrenia (ALTO) study.

Author information

1
University Hospital Center, EA 7280 University Clermont Auvergne, Clermont-Ferrand, France.
2
Department of Psychiatry - CIBERSAM, University of Oviedo, Oviedo, Spain.
3
Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry, Medical University Innsbruck, Innsbruck, Austria.
4
Department of Psychiatry and Psychotherapy, Munich Technical University, Munich, Germany.
5
Department of Pharmacology, University of Bordeaux, Bordeaux, France.
6
Lundbeck SAS, Issy-les-Moulineaux, France.
7
Otsuka Pharmaceutical Europe Ltd., Wexham, United Kingdom.
8
H. Lundbeck A/S, Ottiliavej 9, Valby, 2500, Denmark. Electronic address: AGN@lundbeck.com.
9
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Abstract

BACKGROUND:

The Antipsychotic Long-acTing injection in schizOphrenia (ALTO) study was a non-interventional study across several European countries examining prescription of long-acting injectable (LAI) antipsychotics to identify sociodemographic and clinical characteristics of patients receiving and physicians prescribing LAIs. ALTO was also the first large-scale study in Europe to report on the use of both first- or second-generation antipsychotic (FGA- or SGA-) LAIs.

METHODS:

Patients with schizophrenia receiving a FGA- or SGA-LAI were enrolled between June 2013 and July 2014 and categorized as incident or prevalent users. Assessments included measures of disease severity, functioning, insight, well-being, attitudes towards antipsychotics, and quality of life.

RESULTS:

For the 572 patients, disease severity was generally mild-to-moderate and the majority were unemployed and/or socially withdrawn. 331/572 were prevalent LAI antipsychotic users; of whom 209 were prescribed FGA-LAI. Paliperidone was the most commonly prescribed SGA-LAI (56% of incident users, 21% of prevalent users). 337/572 (58.9%) were considered at risk of non-adherence. Prevalent LAI users had a tendency towards better insight levels (PANSS G12 item). Incident FGA-LAI users had more severe disease, poorer global functioning, lower quality of life, higher rates of non-adherence, and were more likely to have physician-reported lack of insight.

CONCLUSIONS:

These results indicate a lower pattern of FGA-LAI usage, reserved by prescribers for seemingly more difficult-to-treat patients and those least likely to adhere to oral medication.

KEYWORDS:

Antipsychotic agents; Long-acting injectable; Medication adherence; Prescriptions; Schizophrenia

PMID:
29734130
DOI:
10.1016/j.eurpsy.2018.04.004
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