SAN ANTONIO, TX—Patient assistance programs might be one effective strategy for improving adherence with prescribed long-acting atypical antipsychotic injectables among patients with schizophrenia, according to authors of a retrospective cohort study, who presented their findings at the U.S. Psychiatric & Mental Health Congress.
“Over more than four years of program experience, 80.7% of patients who received their injections from the program were observed to be adherent,” reported lead study author Sang Hee Park, MPH, of Boston Health Economics, Inc., in Waltham, MA, and coauthors.
Treatment nonadherence is a frequent problem among people with schizophrenia. One study found that nearly half (49%) of to be medication-nonadherent within 6 months of their discharge from inpatient treatment.
One strategy to increase adherence is to move away from daily oral medications to long-acting injectable (LAI) antipsychotic therapies, such as once-monthly paliperidone palmitate or twice-monthly risperidone. Another adherence-improvement strategy, adopted by some drug companies, has been to provide patient information programs, such as Janssen Connect.
Jansen Connect was initiated in 2010 as a patient-information and patient financial assistance program for patients prescribed the LAIs paliperidone palmitate or risperidone. The program offers financial aid and access to medication and medication injection location support, shipment of medications, patient transition support, and reminder-alert services.
The study authors sought to assess medication adherence after 1 year among patients enrolled in the program and to identify patient subgroup adherence disparities.
They analyzed data for 1,693 adult patients enrolled between December 2010 and 2015 who had received ≥2 injections of paliperidone palmitate LAI and who did not switch to risperidone.
LAI dispensing outside the program could not be assessed, the authors cautioned: “[O]nly patients receiving their LAI through the program were included in the analysis, limiting the generalizability of the results to those patients enrolled in the program.”
Fifty-eight percent of patients included in the analysis were age 35 years or older at enrollment; 59.5% were male; and 74% were enrolled in Medicare or Medicaid public insurance programs.
Adherence analyses usually employ drug-refill or prescription date data but this analysis used data on injection dates, the authors noted. Adherence was evaluated for the year following first injection. Adherence was defined as a medication possession ratio (MPR) >0.8.
The median 1-year MPR was 0.93 (0.83–0.98) and median number of injections received was 9 (4–12).
“Comparable adherence rates were observed across different subgroups, including those groups that typically have challenges in adhering to their medications,” the research team reported.
“The biggest gap observed was among patients with other government coverage (excluding Medicaid and Medicare), where only 64% were adherent (n=69),” they noted. (The authors did not specify the government programs in question, but in addition to Medicare and Medicaid, the US government offers health care insurance or coverage through the military, Veterans Health Administration, and Indian Health Service.)
The study was funded by Janssen Scientific Affairs, LLC. A coauthor of the paper, Carmela Benson, MS, MSHP, is an employee of Janssen.