Real-World Evidence of Aripiprazole Tablets with Sensor: Treatment Patterns and Impacts on Psychiatric Healthcare Resource Utilization

Figures & data

Figure 1 Participant disposition.

Notes: ^aIncluded participants with claims for AS obtained through Orsini Specialty Pharmacy.

Abbreviations: AP, antipsychotic; AS, aripiprazole tablets with sensor; yrs, years.

Table 1 Participant Demographics and Baseline Characteristics

Parameter	AP Controls (n = 196)	AS Initiators (n = 49)	P value	SMD
Gender, n (%)			NS
Female	119 (60.7)	30 (61.2)		0.01
Male	77 (39.2)	19 (38.8)		0.01
Years of age, mean (SD)	37.5 (15.7)	37.7 (14.1)	NS	0.01
Insurance type, n (%)			NS
Commercial	91 (46.2)	22 (44.9)		0.03
Medicaid	93 (47.1)	24 (49.0)		0.04
Medicare	12 (6.6)	3 (6.1)		0.02
Index primary diagnosis, n (%)			NS
MDD	118 (60.2)	30 (61.2)		0.02
Bipolar disorder	19 (9.6)	5 (10.2)		0.02
Schizophrenia	28 (14.3)	6 (12.2)		0.06
Bipolar disorder and schizophrenia	4 (2.0)	1 (2.0)		0.0
MDD and schizophrenia	2 (1.0)	1 (2.0)		0.08
Other^a	25 (12.7)	6 (12.2)		0.02
None	0 (0)	0 (0)		0.0
Baseline psychiatric comorbidities, n (%)				N/A
Post-traumatic stress disorder	12 (6.1)	7 (14.3)	NS
Anxiety	17 (8.7)	7 (14.3)	NS
Insomnia	3 (1.5)	5 (10.2)	<0.05
Sleep-wake disorder	4 (2.0)	8 (16.3)	<0.01
Substance use and addiction disorders	26 (13.3)	3 (6.1)	<0.05
Charlson Comorbidity Index, mean (SD)	0.31 (0.8)	0.45 (1.1)	NS	N/A
Baseline medications utilization, n (%)
Antipsychotics	60 (30.6)	12 (24.5)	NS	0.1
Baseline psychiatric utilization, ^bmean (SD)			NS
Outpatient visits	2.4 (5.7)	2.1 (4.8)		0.05
Other medical services	2.9 (5.5)	2.0 (4.1)		0.1
ED visits	0.07 (0.13)	0.04 (0.11)		0.2
Inpatient hospitalization	0.5 (0.2)	0.2 (0.12)		1.8
Pharmacy	0.9 (0.6)	0.6 (0.4)		0.5

Notes: ^aIncluding anxiety and post-traumatic stress disorder. ^bPer participant per month.

Abbreviations: AP, antipsychotic; AS, aripiprazole tablets with sensor; ED, emergency department; MDD, major depressive disorder; N/A, not available; NS, not statistically significant; SD, standard deviation; SMD, standardized mean difference.

Table 2 Psychiatric Medication Utilization at Baseline and Follow-Up

Medications Utilized	AP Controls (n = 196)			AS Initiators (n = 49)
	Baseline	Follow-Up	P value	Baseline	Follow-Up	P value
AP usage, n (%)
No	136 (69.3)	0 (0)		37 (75.5)	0 (0)
Yes	60 (30.6)	196 (100)	<0.05	12 (24.5)	49 (100)	<0.05
AP type, n (%)^a
Aripiprazole^b	18 (9.2)	62 (31.6)		10 (20.4)	42 (85.7)
Quetiapine	24 (12.2)	70 (35.7)		0 (0)	0 (0)
Other^c	28 (14.3)	89 (45.4)		2 (4.1)	4 (8.2)
Long-acting injectable, n (%)^c	0 (0)	4 (2.0)	NS	2 (4.1)	2 (4.1)	NS
Antidepressants, n (%)	90 (45.9)	148 (75.5)	<0.05	11 (22.4)	8 (16.3)	NS
Anxiolytics, n (%)	21 (10.7)	24 (12.2)	NS	2 (4.1)	1 (2)	NS
Days of AP supply, mean (SD)	11.4 (22.9)	30.5 (21.1)	<0.05	7.7 (18.7)	149.1 (58.0)	<0.05
Days of AS supply, mean (SD)	–	–	–	–	77.1 (58.1)	–

Notes: ^aParticipants could be taking ≥1 type of AP. ^bStandard aripiprazole tablets (non-AS). ^cFor AP controls at baseline, other AP medications included risperidone (n = 14), paliperidone (n = 5), olanzapine (n = 4), ziprasidone (n = 2), chlorpromazine (n = 1), fluphenazine (n = 1), and asenapine (n = 1). For AP controls at follow-up, other AP medications included risperidone (n = 33), olanzapine (n = 28), paliperidone (n = 9), ziprasidone (n = 7), chlorpromazine (n = 5), fluphenazine (n = 5), and asenapine (n = 2). For AS initiators at baseline, other AP medications included risperidone (n = 2). For AS initiators at follow-up, other AP medications included chlorpromazine (n = 2), risperidone (n = 1), and asenapine (n = 1). ^cData on LAIs were not time-stamped other than being within the baseline versus follow-up period and may have been used concurrently with AS or after stopping AS.

Abbreviations: AP, antipsychotic; AS, aripiprazole tablets with sensor; LAI, long-acting injectable; NS, not significant; SD, standard deviation.

Table 3 Adjusted Odds Ratios for Psychiatric HCRU Events Using Zero-Inflated Regression Models

Psychiatric Utilization, PPPM	Zero-Inflated on Total
	Adjusted Odds Ratios^a	P value
ED visits	0.11	<0.1
Inpatient admissions	0.42	<0.05
Outpatient visits	0.80	<0.05
Other medical services^b	0.25	<0.05
Pharmacy claims	0.86	NS

Notes: ^aCoefficient estimates were exponentiated to derive adjusted odds ratios. See Material and Methods for additional details. ^bPsychiatric medical services labeled as “other” included behavioral health screening services, independent laboratory services, medication counseling, and emergency medical screening.

Abbreviations: ED, emergency department; HCRU, healthcare resource utilization; NS, not significant; PPPM, per participant per month.

Figure 2 Frequency of psychiatric HCRU events at baseline and follow-up (unadjusted results).

Notes: (A) Baseline was defined as the 3-month period prior to index date. (B) Follow-up was defined as the 6-month period after index date. ^aServices provided. ^bAdmissions. *P <0.05.

Abbreviations: AP, antipsychotic; AS, aripiprazole tablets with sensor; ED, emergency department; HCRU, healthcare resource utilization; NS, not significant; PPPM, per participant per month.