Effect of Transition to Long-acting Injectable Antipsychotic Treatment on Care Burden in Schizophrenia

Yıl 2021, , 361 - 374, 29.12.2021

Elif Özcan Tozoğlu , Gökhan Özpolat

https://doi.org/10.18863/pgy.991538

Öz

The main aim of this study is to investigate the difference of transition from oral to long-acting antipsychotic treatments on caregiver burden of patients with schizophrenia. Other factors that may be related to the burden were also discussed. Caregivers (n:138) of patients diagnosed with schizophrenia for at least one year and who received oral paliperidone or aripiprazole were included in the study. The Zarit Caregiver Burden Scale (ZCBS) and The Clinical Global Impression-Disease Severity (CGI-S) were administered at baseline and 1 year after switching to long-acting injectables. Demographic characteristics of caregivers and patients were evaluated to determine other factors associated with the burden. Significant decreases were found in the ZCBS and CGI-S scores after transitioning to long-acting injectable antipsychotics. When the groups using paliperidone and aripiprazole were compared; the decrease in ZCBS scores was not significant, the decrease in CGI-S scores was significant.Caregiver burden was positively correlated with patient's age, CGI-S score, time spent in the same house, duration of illness, and the number of hospitalizations. A significant negative correlation was found among the caregiver’s age, educational level and income. In conclusion, in the present study the importance of switching to long-acting injectable antipsychotics, which is a modifiable factor, to reduce caregiver burden was emphasized.

Anahtar Kelimeler

Schizophrenia, long-acting injection treatment, caregiver, caregiver burden

Şizofrenide Uzun Etkili Enjektabl Antipsikotik Tedaviye Geçişin Bakım Yükü Üzerine Etkisi

Öz

Bu çalışmadaki temel amacımız, oral tedaviden uzun etkili antipsikotik tedavilere geçişin şizofreni hastalarında bakım veren yükü üzerinde oluşturduğu farkı araştırmaktır. Yükle ilgili olabilecek diğer faktörler de tartışılmıştır. Çalışmaya en az bir yıldır şizofreni tanısı almış ve oral paliperidon veya aripiprazol alan hastaların bakıcıları (n:138) dahil edildi. Zarit Bakıcı Yükü Ölçeği (ZBYÖ) ve Klinik Global İzlenim-Hastalık Şiddeti (KGİÖ-Ş) ölçeği başlangıçta ve uzun etkili enjektabl antipsikotiklere geçişten 1 yıl sonra uygulandı. Bakım yükü ile ilişkili olabilecek diğer faktörler de ele alındı. Uzun etkili enjekte edilebilir antipsikotiklere geçildikten sonra ZBYÖ ve KGİÖ-Ş puanlarında anlamlı düşüşler bulund. Paliperidon ve aripiprazol kullanan gruplar karşılaştırıldığında; ZBYÖ puanlarındaki düşüş anlamlı değilken, KGİÖ-Ş puanlarındaki düşüş anlamlıydı. Bakım veren yükü, hastanın yaşı, KGİÖ-Ş puanı, aynı evde geçirilen süre, hastalık süresi ve hastaneye yatış sayısı ile pozitif korelasyon gösterdi. Bakım verenin yaşı, eğitim düzeyi ve geliri arasında anlamlı negatif ilişki bulundu. Sonuç olarak bu çalışmada bakım veren yükünün azaltılmasında değiştirilebilir bir faktör olan uzun etkili enjekte edilebilir antipsikotiklere geçilmesinin önemi vurgulanmıştır.

Anahtar Kelimeler

Şizofreni, uzun etkili enjeksiyon tedavisi, antipsikotik tedavi, bakım veren, bakıcı yükü

Kaynakça

• Referans1 Pereira MAO, Barbieri L, Paula VPd, Franco MdSP. Mental health in the family health program: the conceptions of community agents about mental illness. Revista da Escola de Enfermagem da USP. 2007;41(4):567-72.
• Referans 2 Schene AH, van Wijngaarden B, Koeter MW. Family caregiving in schizophrenia: domains and distress. Schizophrenia bulletin. 1998;24(4):609-18.
• Referans 3 Martinez A, Nadal S, Beperet M, Mendióroz P. The schizophrenic patient and his/her relatives: a process of deep change. An Sist Sanit Navarra. 2000;23(1):101-10.
• Referans 4 Martens L, Addington J. The psychological well-being of family members of individuals with schizophrenia. Social psychiatry and psychiatric epidemiology. 2001;36(3):128-33.
• Referans 5 Ochoa S, Vilaplana M, Haro JM, Villalta-Gil V, Martínez F, Negredo MC, et al. Do needs, symptoms or disability of outpatients with schizophrenia influence family burden? Social psychiatry and psychiatric epidemiology. 2008;43(8):612-8.
• Referans 6 Saunders JC. Families living with severe mental illness: A literature review. Issues in mental health nursing. 2003;24(2):175-98.
• Referans 7 Chan SW-c. Global perspective of burden of family caregivers for persons with schizophrenia. Archives of psychiatric nursing. 2011;25(5):339-49.
• Referans 8 Atkinson JM, Coia DA. Families coping with schizophrenia: A practitioner's guide to family groups: John Wiley & Sons; 1995.
• Referans 9 Zhou Y, Ning Y, Rosenheck R, Sun B, Zhang J, Ou Y, et al. Effect of living with patients on caregiver burden of individual with schizophrenia in China. Psychiatry research. 2016;245:230-7.
• Referans 10 Wolthaus JE, Dingemans PM, Schene AH, Linszen DH, Wiersma D, Van Den Bosch RJ, et al. Caregiver burden in recent-onset schizophrenia and spectrum disorders: the influence of symptoms and personality traits. The Journal of nervous and mental disease. 2002;190(4):241-7.
• Referans 11 McDonell MG, Short RA, Berry CM, Dyck DG. Burden in schizophrenia caregivers: impact of family psychoeducation and awareness of patient suicidality. Family process. 2003;42(1):91-103.
• Referans 12 Reine G, Lancon C, Simeoni M, Duplan S, Auquier P. Caregiver burden in relatives of persons with schizophrenia: an overview of measure instruments. L'encéphale. 2003;29(2):137.
• Referans 13 Perlick DA, Rosenheck RA, Kaczynski R, Swartz MS, Cañive JM, Lieberman JA. Special section on CATIE baseline data: components and correlates of family burden in schizophrenia. Psychiatric services. 2006;57(8):1117-25.
• Referans 14 Awad AG, Voruganti LN. The burden of schizophrenia on caregivers. Pharmacoeconomics. 2008;26(2):149-62.
• Referans 15 Jagannathan A, Thirthalli J, Hamza A, Nagendra H, Gangadhar B. Predictors of family caregiver burden in schizophrenia: Study from an in-patient tertiary care hospital in India. Asian journal of psychiatry. 2014;8:94-8.
• Referans 16 Ohaeri JU. Caregiver burden and psychotic patients' perception of social support in a Nigerian setting. Social psychiatry and psychiatric epidemiology. 2001;36(2):86-93.
• Referans 17 AYDIN A, EKER SS, CANGÜR Ş, SARANDÖL A, KIRLI S. Şizofreni Hastalarında Bakım Veren Külfet Düzeyinin, Sosyodemografik Değişkenler ve Hastalığın Özellikleri ile İlişkisi. Archives of Neuropsychiatry/Noropsikiatri Arsivi. 2009;46.
• Referans 18 Grandón P, Jenaro C, Lemos S. Primary caregivers of schizophrenia outpatients: Burden and predictor variables. Psychiatry research. 2008;158(3):335-43.
• Referans 19 Leucht S, Tardy M, Komossa K, Heres S, Kissling W, Salanti G, et al. Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. The Lancet. 2012;379(9831):2063-71.
• Referans 20 Gilmer TP, Dolder CR, Lacro JP, Folsom DP, Lindamer L, Garcia P, et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. American Journal of Psychiatry. 2004;161(4):692-9.
• Referans 21 Higashi K, Medic G, Littlewood KJ, Diez T, Granström O, De Hert M. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review. Therapeutic advances in psychopharmacology. 2013;3(4):200-18. Referans 22 Lacro JP, Dunn LB, Dolder CR, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. The Journal of clinical psychiatry. 2002;63(10):892-909.
• Referans 23 Patel MX, Taylor M, David AS. Antipsychotic long-acting injections: mind the gap. The British Journal of Psychiatry. 2009;195(S52):s1-s4.
• Referans 24 Novick D, Haro JM, Suarez D, Perez V, Dittmann RW, Haddad PM. Predictors and clinical consequences of non-adherence with antipsychotic medication in the outpatient treatment of schizophrenia. Psychiatry research. 2010;176(2-3):109-13.
• Referans 25 Brissos S, Veguilla MR, Taylor D, Balanzá-Martinez V. The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal. Therapeutic advances in psychopharmacology. 2014;4(5):198-219.
• Referans 26 Schooler NR. Relapse and rehospitalization: comparing oral and depot antipsychotics. The Journal of clinical psychiatry. 2003;64:14-7.
• Referans 27 Lafeuille M-H, Laliberté-Auger F, Lefebvre P, Frois C, Fastenau J, Duh MS. Impact of atypical long-acting injectable versus oral antipsychotics on rehospitalization rates and emergency room visits among relapsed schizophrenia patients: a retrospective database analysis. BMC psychiatry. 2013;13(1):221.
• Referans 28 Heres S, Lambert M, Vauth R. Treatment of early episode in patients with schizophrenia: the role of long acting antipsychotics. European Psychiatry. 2014;29(S2):1409-13.
• Referans 29 Markowitz M, Fu D-J, Levitan B, Gopal S, Turkoz I, Alphs L. Long-acting injectable paliperidone palmitate versus oral paliperidone extended release: a comparative analysis from two placebo-controlled relapse prevention studies. Annals of General Psychiatry. 2013;12(1):22.
• Referans 30 Yoshimura B, Shinkawa I, Konishi A. Hospitalization risk in patients with schizophrenia before and after initiation of risperidone long-acting injection in Japan. Asian journal of psychiatry. 2015;14:67.
• Referans 31 Castillo EG, Stroup TS. Effectiveness of long-acting injectable antipsychotics: a clinical perspective. Evidence-Based Mental Health. 2015;18(2):36-9.
• Referans 32 Sreeraj VS, Shivakumar V, Rao NP, Venkatasubramanian G. A critical appraisal of long acting injectable antipsychotics: translating research to clinics. Asian journal of psychiatry. 2017;28:57-64.
• Referans 33 Ozlu A, Yildiz M, Aker T. A reliability and validity study on the Zarit caregiver burden scale. 2009.
• Referans 34 Hulya A, Adana F. The Burden of Schizophrenia on Caregivers. Current Approaches in Psychiatry. 2011;3:251-77.
• Referans 35 Nolan M. Supporting family carers in the UK: overview of issues and challenges. British Journal of Nursing. 2001;10(9):608-13.
• Referans 36 Cheng L-Y, Chan S. Psychoeducation program for Chinese family carers of members with schizophrenia. Western journal of nursing research. 2005;27(5):583-99.
• Referans 37 Chan SW-c, Yip B, Tso S, Cheng B-s, Tam W. Evaluation of a psychoeducation program for Chinese clients with schizophrenia and their family caregivers. Patient education and counseling. 2009;75(1):67-76.
• Referans 38 Cassidy E, Hill S, O’callaghan E. Efficacy of a psychoeducational intervention in improving relatives’ knowledge about schizophrenia and reducing rehospitalisation. European Psychiatry. 2001;16(8):446-50.
• Referans 39 Caqueo-Urízar A, Urzúa A, Jamett PR, Irarrazaval M. Objective and subjective burden in relatives of patients with schizophrenia and its influence on care relationships in Chile. Psychiatry research. 2016;237:361-5.
• Referans 40 Kretchy IA, Osafo J, Agyemang SA, Appiah B, Nonvignon J. Psychological burden and caregiver-reported non-adherence to psychotropic medications among patients with schizophrenia. Psychiatry research. 2018;259:289-94.
• Referans 41 Adeosun II. Correlates of caregiver burden among family members of patients with schizophrenia in Lagos, Nigeria. Schizophrenia research and treatment. 2013;2013.
• Referans 42 Nasr T, Kausar R. Psychoeducation and the family burden in schizophrenia: a randomized controlled trial. Annals of general psychiatry. 2009;8(1):17.
• Referans 43 Gülseren L, Cam B, Karakoç B, Yiğit T, Danacı A, Çubukçuoğlu Z, et al. The perceived burden of care and its correlates in schizophrenia. Turk Psikiyatri Derg. 2010;21(3):203-12.
• Referans 44 Guarnaccia PJ, Parra P. Ethnicity, social status, and families' experiences of caring for a mentally ill family member. Community Mental Health Journal. 1996;32(3):243-60.
• Referans 45 Hacialioglu N, Özer N, Erdem N, Erci B. The quality of life of family caregivers of cancer patients in the East of Turkey. European Journal of Oncology Nursing. 2010;14(3):211-7.
• Referans 46 Montero I, Masanet M, Lacruz M, Bellver F, Asencio A, García E. Family intervention in schizophrenia: long-term effect on main caregivers. Actas espanolas de psiquiatria. 2006;34(3):169-74.
• Referans 47 Loukissa DA. Family burden in chronic mental illness: a review of research studies. Journal of advanced nursing. 1995;21(2):248-55.
• Referans 48 Sennekamp W. Aspects of emotional stress on relatives of schizophrenic patients. Psychiatrische Praxis. 1995;22(1):27-9.
• Referans 49 Jungbauer J, Mory C, Angermeyer M. Does caring for a schizophrenic family member increase the risk of becoming ill? Psychological and psychosomatic troubles in caregivers of Schizophrenia patients. Fortschritte der Neurologie-Psychiatrie. 2002;70(10):548.
• Referans 50 Caqueo-Urízar A, Gutiérrez-Maldonado J. Burden of care in families of patients with schizophrenia. Quality of Life Research. 2006;15(4):719-24.
• Referans 51 Gutiérrez-Maldonado J, Caqueo-Urízar A. Effectiveness of a psycho-educational intervention for reducing burden in Latin American families of patients with schizophrenia. Quality of Life Research. 2007;16(5):739-47.
• Referans 52 Chien WT, Chan SW, Morrissey J. The perceived burden among Chinese family caregivers of people with schizophrenia. Journal of clinical nursing. 2007;16(6):1151-61.
• Referans 53 Magaña SM, Ramirez Garcia JI, Hernández MG, Cortez R. Psychological distress among Latino family caregivers of adults with schizophrenia: The roles of burden and stigma. Psychiatric services. 2007;58(3):378-84.
• Referans 54 Yazici E, Karabulut Ü, Yildiz M, Tekeş SB, Inan E, Çakir U, et al. Burden on caregivers of patients with schizophrenia and related factors. Nöro Psikiyatri Arşivi. 2016;53(2):96.
• Referans 55 Cook JA, Lefley HP, Pickett SA, Cohler BJ. Age and family burden among parents of offspring with severe mental illness. American journal of orthopsychiatry. 1994;64(3):435-47.
• Referans 56 Magaña S, Smith MJ. Health outcomes of midlife and older Latina and Black American mothers of children with developmental disabilities. Mental Retardation. 2006;44(3):224-34.
• Referans 57 Coşkun S, Güven Caymaz N. Bir Kamu ve Özel Psikiyatri Hastanesine Başvuran Hastaların İçselleştirilmiş Damgalanma Düzeyi Yönünden Karşılaştırılması. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi. 2012;3(3).
• Referans 58 Webb C, Pfeiffer M, Mueser KT, Gladis M, Mensch E, DeGirolamo J, et al. Burden and well-being of caregivers for the severely mentally ill: The role of coping style and social support. Schizophrenia research. 1998.
• Referans 59 Ricard N, Bonin J-P, Ezer H. Factors associated with burden in primary caregivers of mentally ill patients. International Journal of Nursing Studies. 1999;36(1):73-83.
• Referans 60 Çobanoğlu ZSÜ, Aker T, Çobanoğlu N. Şizofreni ve diğer psikotik bozukluğu olan hastalarda tedaviye uyum sorunları. Düşünen Adam. 2003;16:211-8.
• Referans 61 Waddell L, Taylor M. Attitudes of patients and mental health staff to antipsychotic long-acting injections: systematic review. The British journal of psychiatry. 2009;195(S52):s43-s50.
• Referans 62 Ceylan MF, Erdogan B, Hesapcioglu ST, Cop E. Effectiveness, adverse effects and drug compliance of long-acting injectable risperidone in children and adolescents. Clinical drug investigation. 2017;37(10):947-56.
• Referans 63 Patel MX, David AS. Why aren't depot antipsychotics prescribed more often and what can be done about it? Advances in psychiatric treatment. 2005;11(3):203-11.
• Referans 64 Olfson M, Marcus SC, Ascher-Svanum H. Treatment of schizophrenia with long-acting fluphenazine, haloperidol, or risperidone. Schizophrenia bulletin. 2007;33(6):1379-87.
• Referans 65 Schooler NR. Relapse and rehospitalization: comparing oral and depot antipsychotics. The Journal of clinical psychiatry. 2003;64(suppl 16):14-7.
• Referans 66 Bhanji NH, Chouinard G, Margolese HC. A review of compliance, depot intramuscular antipsychotics and the new long-acting injectable atypical antipsychotic risperidone in schizophrenia. European Neuropsychopharmacology. 2004;14(2):87-92.
• Referans 67 Titus-Lay EN, Ansara ED, Isaacs AN, Ott CA. Evaluation of adherence and persistence with oral versus long-acting injectable antipsychotics in patients with early psychosis. Mental Health Clinician. 2018;8(2):56-62.
• Referans 68 Marcus SC, Zummo J, Pettit AR, Stoddard J, Doshi JA. Antipsychotic adherence and rehospitalization in schizophrenia patients receiving oral versus long-acting injectable antipsychotics following hospital discharge. Journal of managed care & specialty pharmacy. 2015;21(9):754-69.
• Referans 69 McCreath J, Larson E, Bharatiya P, Labanieh HA, Weiss Z, Lozovatsky M. Long-Acting Injectable Antipsychotics for Schizophrenia: Sociodemographic Characteristics and Treatment Adherence. The primary care companion for CNS disorders. 2017;19(1).
• Referans 70 De Marinis T, Saleem P, Glue P, Arnoldussen W, Teijeiro R, Lex A, et al. Switching to long-acting injectable risperidone is beneficial with regard to clinical outcomes, regardless of previous conventional medication in patients with schizophrenia. Pharmacopsychiatry. 2007;40(06):257-63.
• Referans 71 Rothbard AB, Kuno E, Foley K. Trends in the rate and type of antipsychotic medications prescribed to persons with schizophrenia. Schizophrenia Bulletin. 2003;29(3):531-40.