Florida Atlantic University's Charles E. Schmidt College of Medicine was recently awarded a $2.1 million, two-year contract by Otsuka America Pharmaceutical Inc. to conduct a study to examine the effectiveness of an injectable long-acting antipsychotic medication for schizophrenia and its impact on 30-day hospital readmission rates.
In patients with severe illnesses such as schizophrenia, the risk for relapse and re-hospitalization is substantially increased following hospitalizations. Efforts to promote the use of evidence-based treatments that reduce relapse, improve clinical outcomes and contain health care costs, especially in chronic illnesses, have been a major focus of health quality improvement initiatives in the United States.
"This research is important because the availability of second-generation long-acting antipsychotic medications offers an important tool to assist patients with medication adherence, which in turn may help lower health care costs and improve quality of life," said John W. Newcomer, M.D., principal investigator of the study, executive vice dean of FAU's Charles E. Schmidt College of Medicine, and a physician-scientist who has been studying schizophrenia for more than 25 years.
According to the Agency for Healthcare Research and Quality (Healthcare Cost and Utilization Project), schizophrenia and other psychotic disorders are listed as No. 2 in the top 10, 30-day readmissions for Medicaid patients (aged 18-64 years). They accounted for 35,800 readmissions (24.9 per 100 admissions) with $302 million in readmissions costs in 2011.
FAU is the coordinating site for this multi-center, longitudinal clinical trial and will work with faculty collaborators at Washington University in St. Louis School of Medicine as well as other sites. The team will evaluate hospitalization rates and metabolic measurements during treatment with long-acting injectable aripiprazole compared with daily oral antipsychotic treatment in the six months following an inpatient hospital stay related to schizophrenia.
This study is a collaboratively designed, investigator-initiated study that will be conducted across five other centers in the U.S. in addition to FAU: Washington University School of Medicine, University of Missouri-Kansas City, University of Missouri-Columbia, Missouri Institute of Mental Health and Burrell Behavioral Health.
"There is great interest from clinicians, policy-makers, and health care administrators on the effect of new medications in containing health care costs," said Newcomer. "We will be investigating an injectable long-acting antipsychotic medication and its impact on hospital readmission rates in the high-cost population of patients with schizophrenia who use hospital services."
The Centers for Medicare and Medicaid Services (CMS) has focused interest on 30-day hospital readmission rates as an indicator of cost-effective health care delivery. The American College of Emergency Physicians and American Hospital Association reported a 13 percent increase in behavioral health-related hospital emergency department visits between 2005 and 2012.
Schizophrenia is a serious mental illness that interferes with a person's ability to relate to others, think clearly, make decisions and manage emotions. Symptoms of the illness can include hallucinations, cognitive issues, confusion, psychosis and withdrawn behavior. There is currently no cure for schizophrenia, however it can be treated and managed in several ways such as antipsychotic medications and psychotherapy. In the U.S., approximately 2.2 million adults age 18 and older in a given year have schizophrenia.
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