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Comparison of short-acting intramuscular antipsychotic medication: impact on length of stay and cost.
MedLine Citation:
PMID:  20335789     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
A retrospective cohort study was conducted to determine if there is an association between short-acting intramuscular (SAIM) antipsychotics used for acute agitation and length of stay (LOS). Patients with a diagnosis of schizophrenia or schizoaffective disorder who were dispensed at least one dose of a SAIM antipsychotic were divided into groups based on the initial SAIM antipsychotic received once admitted to a psychiatric unit. Electronic records were used to gather demographic information, LOS, and number of injections received during an admission. Cost was calculated from the number of injections received. One-hundred and thirty-six patients were enrolled. When comparing the haloperidol group to the second generation antipsychotic group, there was no statistically significant difference, in LOS 16.98 ± 9.56 days versus 17.59 ± 11.52 days (P = 0.75), respectively. There was a statistically significant difference in both cost and number of injections between groups, favoring the haloperidol group. Ziprasidone was associated with a shorter LOS compared with olanzapine, 13.57 and 19.10 days, respectively (P = 0.026). Patient characteristics should be evaluated when determining an agent for acute agitation. However, because literature indicates second generation SAIM antipsychotics are only noninferior to haloperidol; other factors should also be evaluated; including impact on LOS and impact on hospital resources. This study indicates use of a second generation SAIM antipsychotic for acute agitation is more costly, requires more injections, and was not associated with a shorter length of stay when compared with SAIM haloperidol.
Authors:
Jonathan G Leung; Amanda M Benedetti; Lawrence A Frazee; Nancy Myers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of therapeutics     Volume:  18     ISSN:  1536-3686     ISO Abbreviation:  Am J Ther     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  300-4     Citation Subset:  IM    
Affiliation:
1Virginia Commonwealth University Health System, Richmond, VA; 2Cancer Pain Program, Akron General Medical Center Department of Pharmacy, Akron, OH; 3Department of Internal Medicine, Akron General Medical Center, Akron, OH; and 4Northeastern Ohio Universities Colleges of Medicine and Pharmacy, Rootstown, OH.
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