REDUCTION OF HOSPITAL DAYS IN CHRONIC-SCHIZOPHRENIC PATIENTS TREATED WITH RISPERIDONE - A RETROSPECTIVE STUDY

Hospital costs for chronic schizophrenic patients consume a major shar e of the cost of mental health care. Despite the success of numerous c ommunity mental health programs, repeated hospital admission of schizo phrenic patients is a significant problem. Effective therapy and compl iance with that therapy are two important factors in reducing hospital ization. Adverse effects of antipsychotic agents, particularly extrapy ramidal symptoms (EPS), negatively influence compliance. A new antipsy chotic agent, risperidone, has demonstrated efficacy against both posi tive and negative symptoms of schizophrenia and has been associated wi th a low incidence of EPS. To assess the potential of risperidone ther apy to reduce the number of days in the hospital, a retrospective anal ysis was undertaken of data from a year-long clinical trial of risperi done. For 27 patients who had completed 365 days of open-label therapy with risperidone, the number of hospital days during this period was compared with the number of hospital days in the preceding 365-day per iod, when the patients were receiving conventional antipsychotic medic ation. The mean number of hospital days was reduced from 106 to 85 day s, for a 20% reduction (P=0.003) after the initiation of risperidone. Three subgroups of patients were apparent: (1) those who had spent no time in the hospital in the pre-risperidone year, (2) those who had be en continuously hospitalized in the pre-risperidone year, and (3) thos e who had spent part of the pre-risperidone year (3 to 165 days) in th e hospital. A 73% reduction (P = 0.0009) in mean hospital days (from 4 9 to 13 days) was achieved in the third subgroup (n = 14). These findi ngs suggest that risperidone may have a role in reducing hospital days for the chronic schizophrenic population.