Title: Effects of long-acting injectable antipsychotics on likelihood of inpatient psychiatric readmission within 90 days
Authors: Erin M. Seddon, PharmD; Autumn Peck, PharmD, MBA; Stephen Kazmer, PharmD; Anna Marie Fink, PharmD.
Objective: Audience members will be able to assess the benefits of Long-Acting Injectable Antipsychotics on readmission rates compared to oral antipsychotics.
Self-Assessment Question: This study showed a statistically significant difference in readmission rates between those prescribed a long-acting injectable antipsychotic vs those prescribed an oral only regimen (True or False)
Methods: A retrospective chart review of patients meeting inclusion criteria was conducted to determine the rate of 90-day readmission, with data collected from August 1, 2022, until July 31, 2025; included patients were at least 18 years of age and had an index psychiatric admission lasting at least 5 days. Patients were excluded if the long-acting injectable received was intramuscular naltrexone, had a sole diagnosis of any substance use disorder, and/or a diagnosis of dementia or a dementia related disorder. The primary outcome of 90-day psychiatric readmission was analyzed using a Chi-Square test for large sample nominal data. Secondary outcomes (ED presentation within 90 days; differences in rate of ED presentation or admission between LAIAs) were evaluated using an unpaired T-test to normal distribution interval/ratio data. Baseline characteristics and other confounding variables were compared between groups and evaluated using descriptive statistics.
Results: Investigators observed a lower rate of 90-day psychiatric readmissions in patients prescribed a LAIA vs. those prescribed an oral only regimen, with readmission rates of 20% vs. 24%, (p=0.629). Mean time to readmission was observed to be lower in the LAIA group (22 days) vs the oral only group (37 days), showing a shorter time to readmission in those prescribed a LAIA. Of the six LAIA studied, four agents were found to have associated readmissions, with Abilify Maintena and Uzedy having no associated readmissions. A lower rate of 90-day ED presentations was seen in the LAIA group vs the oral group with rates of 10% vs 12% respectively, (p= 0.749). Mean time to ED presentation was observed to be 17 days in both groups
Conclusion: Investigators saw a non-statistically significant lower rate of 90-day readmissions and ED presentations with LAIAs. Two of the LAIA studied had no readmissions. Further research is needed regarding the incidence of 90-day readmissions between LAIA and oral only regimens, as well as the impact of demographic factors on readmission. Widespread education on the benefits of LAIAs is indicated to allow for less prescriber hesitation and generate greater evidence for future studies.
