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Long-acting risperidone increases medication costs and does not improve outcomes in unstable schizophrenia

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Question

Question: What is the effect of long-acting injectable (LAI) risperidone on healthcare costs and outcomes in people with unstable schizophrenia or schizoaffective disorder?

Patients: In total, 369 adult patients who had Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) diagnosis of schizophrenia or schizoaffective disorder and were at risk of psychiatric hospitalisation (those hospitalised in the previous 2 years and those whose use of mental health services to prevent relapse had been increasing).

Setting: Nineteen Veterans Affairs medical centres, USA; 2006–2008.

Intervention: LAI risperidone 25–50 mg every 2 weeks or psychiatrist's choice of oral antipsychotic medication (control).

Outcomes: Utilisation of health services and medication (acute medical/surgical hospital stays, acute psychiatry hospital stays, residential and other inpatient hospitalisation and outpatient visits); healthcare cost (inpatient stays, outpatient visits and outpatient medications; analysed from the perspective of the US Medicaid healthcare sponsor); symptoms of schizophrenia using Positive and Negative Syndrome Scale and health-related quality of life using Quality of Well-Being (QWB) Scale.

Patient follow-up: Not reported.

Methods

Design: Randomised controlled trial.

Allocation: Not reported.

Blinding: Single blind (assessors blinded).

Follow-up period: Maximum 24 months (mean 16.2 months).

Main results

There …

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