De. Addington et al., REDUCTION OF HOSPITAL DAYS IN CHRONIC-SCHIZOPHRENIC PATIENTS TREATED WITH RISPERIDONE - A RETROSPECTIVE STUDY, Clinical therapeutics, 15(5), 1993, pp. 917-926
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.