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Table 1 Demographic and clinical characteristics evaluated during the 12-month baseline period in unweighted and IPT-weighted recently diagnosed cohorts

From: Adherence, healthcare resource utilization and Medicaid spending associated with once-monthly paliperidone palmitate versus oral atypical antipsychotic treatment among adults recently diagnosed with schizophrenia

 

Recently diagnosed cohort

Unweighted

IPT-weighted

PP1M (N = 227)

OAA (N = 2168)

Std. Diff. a

PP1M (N = 1107)

OAA (N = 1288)

Std. Diff. a

Age at index date (years), mean ± SD [median]

22.3 ± 1.9 [22.5]

21.6 ± 2.0 [21.7]

31.7%

21.7 ± 2.0 [21.8]

21.7 ± 2.0 [21.8]

0.8%

Female, %

24.7%

41.1%

35.4%

27.9%

39.2%

24.1%

Race, %

 White

43.2%

52.9%

19.5%

49.4%

51.9%

5.0%

 Black

44.1%

34.4%

19.9%

36.6%

35.3%

2.7%

 Hispanic

0.0%

0.5%

9.6%

0.0%

0.5%

9.5%

 Other

5.7%

7.2%

6.0%

5.6%

7.2%

6.2%

 Unknown

7.0%

5.1%

8.1%

8.4%

5.2%

12.6%

State, %

 Iowa

6.6%

12.0%

18.6%

12.8%

11.4%

4.3%

 Kansas

13.7%

8.5%

16.4%

10.1%

9.2%

2.9%

 Mississippi

13.2%

12.8%

1.2%

14.2%

13.0%

3.5%

 Missouri

48.5%

43.2%

10.6%

41.1%

43.5%

4.9%

 New Jersey

18.1%

23.5%

13.4%

21.8%

22.9%

2.5%

Region characteristics, %

 Urban

54.6%

52.3%

4.7%

47.0%

52.1%

10.3%

 Suburban

27.8%

27.1%

1.4%

33.0%

27.2%

12.5%

 Rural

17.6%

20.6%

7.6%

20.0%

20.6%

1.5%

Insurance eligibility, %

 Capitated or dual coverage

63.0%

53.2%

20.0%

56.6%

53.9%

5.3%

  Capitated

48.9%

44.1%

9.5%

47.7%

44.9%

5.5%

  Dual coverage

22.9%

15.5%

19.0%

13.4%

15.8%

6.9%

Year of index date, %

 2009

13.7%

17.7%

11.0%

11.7%

17.1%

15.3%

 2010

43.2%

38.1%

10.3%

41.0%

38.6%

5.0%

 2011

19.4%

21.4%

5.1%

16.7%

21.1%

11.1%

 2012

13.2%

14.2%

2.7%

19.1%

14.3%

13.0%

 2013

9.3%

7.1%

7.7%

9.7%

7.6%

7.8%

 2014

1.3%

1.5%

1.3%

1.7%

1.5%

1.9%

Quan-CCI, mean ± SD [median]

0.3 ± 0.6 [0.0]

0.4 ± 0.8 [0.0]

11.5%

0.4 ± 0.7 [0.0]

0.4 ± 0.8 [0.0]

6.3%

Number of unique mental health diagnoses, mean ± SD [median]

8.1 ± 7.1 [6.0]

8.5 ± 8.1 [6.5]

5.3%

8.9 ± 7.8 [7.0]

8.4 ± 8.0 [7.0]

5.4%

Number of unique AP agents received, mean ± SD [median]

1.8 ± 1.2 [2.0]

1.0 ± 1.1 [1.0]

63.8%

1.2 ± 1.2 [1.0]

1.1 ± 1.1 [1.0]

13.9%

AP use, %

88.1%

59.9%

67.9%

66.6%

62.8%

8.1%

 Typical oral and short-term injectable

24.7%

21.0%

8.7%

23.5%

21.5%

5.0%

 Atypical oral and short-term injectable

68.3%

50.3%

37.2%

55.6%

52.1%

7.0%

 Typical LAI

12.8%

4.2%

30.9%

7.3%

5.2%

8.6%

 Atypical LAI

35.7%

5.3%

81.4%

10.5%

8.5%

6.7%

Proportion of days covered (PDC) by any AP agent, %

 PDC < 0.8b

69.5%

69.5%

0.0%

70.7%

69.5%

2.4%

 PDC ≥ 0.8b

30.5%

30.5%

0.0%

29.3%

30.5%

2.4%

AP polypharmacy presentc, %

19.8%

8.8%

32.0%

11.8%

9.9%

6.1%

Other psychiatric medication use, %

74.4%

69.3%

11.4%

68.9%

69.9%

2.0%

 Antidepressants

47.6%

50.8%

6.4%

49.3%

50.6%

2.5%

 Anxiolytics

35.7%

35.4%

0.6%

34.2%

35.5%

2.7%

 Mood stabilizers

48.5%

42.1%

12.9%

42.6%

42.8%

0.5%

Number of unique psychiatric agents receivedd, mean ± SD [median]

3.6 ± 2.4 [3.0]

2.9 ± 2.7 [2.0]

24.3%

3.0 ± 2.6 [3.0]

3.0 ± 2.7 [3.0]

0.7%

Psychiatric polypharmacy presente, %

42.3%

32.2%

21.0%

31.3%

33.5%

4.8%

Specific comorbidities presentf, %

 Cardiovascular diseaseg

5.3%

6.5%

5.2%

3.2%

6.3%

14.4%

 Diabetes

9.3%

6.8%

8.9%

9.4%

7.4%

7.3%

 Obesity

10.1%

10.9%

2.5%

18.0%

11.0%

19.8%

 Drug abuse

25.1%

20.2%

11.7%

27.4%

20.7%

15.5%

 Hepatitis Cg

0.0%

0.8%

12.6%

0.0%

0.8%

12.7%

 HIV/AIDS

0.0%

0.5%

9.6%

0.0%

0.4%

9.5%

Baseline monthly healthcare costs (2015 $US), mean ± SD [median]

 Total healthcare costs

$2308 ± $3427 [$1408]

$2493 ± $5096 [$1152]

4.3%

$2422 ± $4173 [$1381]

$2526 ± $5012 [$1190]

2.3%

  Total pharmacy costs

$507 ± $644 [$249]

$325 ± $747 [$86]

26.1%

$359 ± $561 [$66]

$340 ± $735 [$97]

2.9%

  Total medical costs

$1802 ± $3215 [$920]

$2169 ± $4941 [$845]

8.8%

$2063 ± $3923 [$933]

$2186 ± $4858 [$885]

2.8%

Baseline healthcare resource utilization, % with ≥1 visit/service

 Outpatient visits

89.9%

89.3%

1.7%

88.3%

89.5%

3.7%

  Number of visits per month, mean ± SD [median]

0.92 ± 1.05 [0.50]

1.03 ± 1.61 [0.58]

8.0%

0.90 ± 1.10 [0.50]

1.03 ± 1.62 [0.58]

9.1%

 Emergency room visits

54.2%

61.2%

14.2%

56.5%

60.8%

8.7%

  Number of visits per month, mean ± SD [median]

0.21 ± 0.47 [0.08]

0.21 ± 0.49 [0.08]

0.6%

0.27 ± 0.55 [0.08]

0.21 ± 0.48 [0.08]

12.4%

 Inpatient visits

52.4%

54.6%

4.4%

58.2%

55.1%

6.4%

  Number of visits per month, mean ± SD [median]

0.15 ± 0.39 [0.08]

0.12 ± 0.23 [0.08]

6.7%

0.14 ± 0.33 [0.08]

0.13 ± 0.24 [0.08]

6.2%

 Long-term care admissions

2.2%

5.5%

17.3%

2.7%

5.7%

15.1%

  Number of admissions per month, mean ± SD [median]

0.00 ± 0.02 [0.00]

0.02 ± 0.13 [0.00]

17.9%

0.00 ± 0.02 [0.00]

0.02 ± 0.12 [0.00]

18.3%

 Mental health institute admissions

63.0%

36.8%

54.3%

49.7%

39.0%

21.8%

  Number of admissions per month, mean ± SD [median]

0.56 ± 0.95 [0.17]

0.27 ± 0.71 [0.00]

34.0%

0.39 ± 0.75 [0.00]

0.31 ± 0.76 [0.00]

10.6%

 One-day mental health institute admissions

70.9%

46.8%

50.5%

56.2%

49.0%

14.4%

  Number of admissions per month, mean ± SD [median]

1.18 ± 1.22 [0.92]

0.51 ± 0.91 [0.00]

62.0%

0.73 ± 1.04 [0.17]

0.58 ± 1.00 [0.00]

14.4%

 Home care

22.9%

29.0%

14.0%

19.9%

29.1%

21.5%

  Number of services per month, mean ± SD [median]

0.55 ± 2.38 [0.00]

0.89 ± 3.74 [0.00]

10.7%

0.34 ± 1.73 [0.00]

0.88 ± 3.70 [0.00]

18.7%

 Other services

30.8%

33.9%

6.5%

34.9%

33.6%

2.6%

  Number of services per month, mean ± SD [median]

0.08 ± 0.23 [0.00]

0.09 ± 0.29 [0.00]

3.2%

0.07 ± 0.16 [0.00]

0.09 ± 0.29 [0.00]

9.5%

  1. AP antipsychotics, CCI Charlson comorbidity index, IPT inverse probability of treatment, LAI long-acting injectable therapy, OAA oral atypical antipsychotics, PDC proportion of days covered, PP1M once-monthly paliperidone palmitate
  2. aBaseline characteristics with a standardized difference <10% were considered well balanced. For continuous variables, the standardized difference is calculated by dividing the absolute difference in means of the PP1M and the OAA cohorts by the pooled standard deviation of both groups. The pooled standard deviation is the square root of the average of the squared standard deviations. For categorical variables with 2 levels, the standardized difference is calculated using the following equation where P is the respective proportion of participants in each group: (PPP1M-POAA)/√[p(1-p)], where p = (PPP1M + POAA)/2
  3. bThe denominator for the proportion of patients with a PDC <0.8 or a PDC ≥0.8 is the number of patients with a PDC >0
  4. cAP polypharmacy is defined as having overlapping coverage of ≥2 unique AP agents for at least 60 consecutive days with no gaps larger than 7 days
  5. dIncludes: mood stabilizers, anxiolytics, antidepressants, and antipsychotics
  6. ePsychiatric polypharmacy is defined as having overlapping coverage of ≥1 AP agent and ≥1 anxiolytic, antidepressant, or mood stabilizer for at least 60 consecutive days with no gaps larger than 7 days
  7. fReference: Elixhauser A, Steiner C, Kruzikas. D. HCUP Methods Series Report # 2004–1. ONLINE February 6, 2004. U.S. Agency for Healthcare Research and Quality. [Internet]. Comorbidity Software Documentation. Rockville, MD, USA; 2004 [cited 2013]. p. 12–5. Available from: http://www.hcup-us.ahrq.gov/reports/ComorbiditySoftwareDocumentationFinal.pdf
  8. gCardiovascular disease was defined using ICD-9-CM codes: 410.xx, 411.0×, 411.81, 411.89, 411.1×, 413.xx, 427.5×, 427.1×, 427.4×, 427.3×, 398.91, 428.xx, 414.0×, 414.1×, 414.8×, 414.9×, 429.3×, 402.9×, 430.xx, 431.xx, 432.xx, 433.xx, 434.xx, 435.xx, 436.xx, 437.xx, 427.89; hepatitis C was defined using the ICD-9 codes: 070.41, 070.44, 070.51, 070.54, 070.7×, V02.62
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BMC Psychiatry

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