35th AM (2024) - Poster Session-Utilization of Psychiatric Services among Patients with Co-Occurring

Utilization of Psychiatric Services among Patients with Co-Occurring

Pdf Summary

The study examines the impact of aripiprazole lauroxil (AL) and paliperidone palmitate (PP) long-acting injectables (LAIs) on psychiatric service utilization among patients with severe mental illness (SMI) and comorbid substance use disorders (SUD). The sample, averaging 44 years of age and predominantly on public insurance, consisted of 53 patients on each LAI, with balanced demographic and clinical characteristics. The key findings indicate no significant difference in readmission rates or time to readmission between the two groups.<br /><br />However, AL was associated with a statistically significant increase in emergency department (ED) visits compared to PP, particularly in patients with active substance use. This difference suggests that AL might be employed for patients with more severe SMI or SUD, potentially increasing their ED utilization. The increased ED visits for AL users, however, did not translate into higher hospitalization rates, suggesting these visits did not reflect severe decompensation. <br /><br />Various explanations for increased ED visits with AL include potentially increased insight into illness, a more help-seeking attitude, or less effectiveness in preventing psychiatric decompensation without leading to hospitalization. The study concludes that while both AL and PP demonstrate similar efficacy in preventing rehospitalization, more research is warranted to understand their differential effects on ED visit rates and to determine the optimal LAI treatment strategy for SMI and SUD patients. Statistical analyses including two-way ANOVAs were used to interpret the data, confirming the significance of the interaction between substance use and antipsychotic treatment on ED visit rates.<br /><br />Overall, this retrospective study highlights the importance of considering both patient characteristics and LAI type in clinical decision-making for treating individuals with SMI and SUD.

Keywords

aripiprazole lauroxil

paliperidone palmitate

long-acting injectables

psychiatric service utilization

severe mental illness

substance use disorders

emergency department visits

rehospitalization

antipsychotic treatment

clinical decision-making

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