Barriers to the use of three-month Paliperidone Palmitate formulation: a study from an Italian real-world setting

ABSTRACT

Background

Long-acting injectable paliperidone can improve adherence in psychotic patients and reduce relapses and healthcare resource utilization (HRU). This study compares the effectiveness of the three-monthly paliperidone palmitate (PP3M) with the one-monthly formulation (PP1M) and investigates reasons that hinder the use of PP3M in real-world settings.

Methods

The authors conducted a three-phase observational study. For subjects recruited from six psychiatric services in Milan, HRU outcomes of PP3M prescription were evaluated through a 12-month mirror-image design (phase 1) and a comparison of HRU of PP1M-only subjects and PP3M subjects during the year prior to PP3M initiation (phase 2). Lastly, they conducted a survey among physicians concerning reasons for not switching to PP3M (phase 3).

Results

A total of 119 subjects (61 on PP3M and 58 on PP1M) were included. One year after PP3M initiation, outpatients’ visits decreased significantly. Comparing PP3M with PP1M subjects, no significant difference was found in HRU. Perception of patient’s unstable clinical condition was the main reason for maintaining PP1M (32.8%), followed by the need for monthly monitoring (19.7%).

Conclusion

PP3M initiation was associated with an overall HRU reduction. Subjects switched to PP3M had similar HRU when compared to those who did not, suggesting similar clinical conditions in both groups.

KEYWORDS:

• Paliperidone palmitate 3-month formulation
• schizophrenia
• health resource use
• hospitalizations
• barriers

Declaration of interest

B Dell’Osso has received lecture honoraria, not related to the work submitted for publication, from Angelini, Janssen Pharmaceuticals, Lundbeck, Livanova, Arcapharma, and Neuraxpharm. V Battini is enrolled in a PhD in Experimental and Clinical Pharmacological Sciences, Università degli Studi di Milano, which supports her fellowship. G Cirnigliaro is supported by ‘Fondazione Romeo ed Enrica Invernizzi’ (Corso Venezia n°32, 20122, Milano (MI)). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Authors’ contributions statement

All authors contributed to the study conception and design. Material preparation and data collection were performed by G Cirnigliaro, E Invernizzi, S Vanzetto, T Prodi, M Macellaro, R Leuzzi, D Conti, and R Cafaro. Data analyses were performed by Vera Battini and Carla Carnovale. The first draft of the manuscript was written by Giovanna Cirnigliaro, Vera Battini, and Bernardo Dell’Osso. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript is not funded.