Evaluation of a comprehensive information and assistance program for patients with schizophrenia treated with long-acting injectable antipsychotics

Abstract

Objective:

While atypical long-acting injectable antipsychotics (LAIs) offer the potential for increased adherence, access to medication poses challenges that may hinder their use. Janssen Connect

*Janssen Connect is a registered trade name of Janssen Scientific Affairs, LLC, Titusville, NJ, USA.

(JC), a comprehensive information and assistance program, was designed to help patients who received a Janssen LAI initiate and maintain treatment after their health care professional (HCP) determined that the medication was the most clinically appropriate option. We conducted a formative and impact evaluation on early medication adherence of patients enrolled in JC and prescribed paliperidone palmitate.

Methods:

Using the program administrative files (December 2010–April 2014), 9354 patients whose HCP ordered paliperidone palmitate were included. Patient demographics, clinical characteristics, and request of JC program offerings were reported overall, and compared between patients requesting the injection center versus those who did not. Medication adherence based on the first 6 months of treatment while in the program and defined as achieving ≥80% proportion of days covered (PDC) was measured for patients receiving ≥2 paliperidone palmitate injections (n = 2659). Logistic models evaluated the association between requests for injection centers on medication adherence.

Results:

Mean age of program enrollees was 40.6 (standard deviation = 13.9 years), 59.3% were men, and 42.5% were Medicare covered. While in the program, 79.9% did not experience a medication gap of ≥7 weeks and 87.0% achieved adherence. Injection center request was associated with medication adherence (adjusted odds ratio (aOR) ≤5 months: 0.03; 95% confidence interval (CI): 0.02–0.05; ≥6 months: aOR: 4.16; 95% CI: 2.72–6.36).

Limitations:

The data sources used were designed for program implementation and not for research purposes.

Conclusions:

The high percentage of patients requesting injection center support and medication shipment in addition to other insurance-related program offerings signals the need for and value of a comprehensive support program for patients seeking LAI therapy. Providing patients with the option of alternative and more conveniently located injection centers may help them start and maintain their treatment.

Keywords: :

• Adherence
• Long-acting injectable antipsychotics
• Persistence
• Schizophrenia

Transparency

Declaration of funding

This research was conducted as part of a consulting agreement with Janssen Scientific Affairs, LLC.

Declaration of financial/other relationships

C.J.B., K.J., and J.F. have disclosed that they are employees of Janssen Scientific Affairs, LLC, and Johnson & Johnson stockholders. K.L.L. has disclosed that she is a paid consultant to Janssen Scientific Affairs, LLC.

Acknowledgments

Jennifer De Camara for her review of the manuscript. Ashanti Brinson and Lisa Biancani (employees of Janssen Pharmaceuticals Inc.) for their review of the program offerings description and for providing the authors insights into the program operations; and Tricia Lopena (employee of Janssen Scientific Affairs, LLC) for her review of the references.

We would also like to thank Matthew Grzywacz, PhD, for editorial assistance (funded by Janssen Scientific Affairs, LLC).

Previous presentation: 2014 US Psychiatric and Mental Health Congress.

Notes

*Janssen Connect is a registered trade name of Janssen Scientific Affairs, LLC, Titusville, NJ, USA.

*Janssen Connect is a registered trade name of Janssen Scientific Affairs, LLC, Titusville, NJ, USA.