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One-year estimate of depot antipsychotic adherence and readmission in Victorian community mental health settings

Published online by Cambridge University Press:  24 June 2014

T Lambert ,
A de Castella ,
A-n Ong ,
J Kulkarni  and
B Singh
T Lambert
Affiliation:
OPEN, The University of Melbourne and ORYGEN Research Centre
A de Castella
Affiliation:
Alfred Psychiatric Research Centre, The Alfred and Monash University
A-n Ong
Affiliation:
Northwestern Mental Health
J Kulkarni
Affiliation:
Alfred Psychiatric Research Centre, The Alfred and Monash University
B Singh
Affiliation:
The University of Melbourne, Australia
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Abstract

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Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006 , pp. 259 - 260
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

This study aimed to 1) to establish the actual or ‘found’ depot adherence rate in typical community psychiatric settings, 2) to describe the sociode-mographic associations with depot adherence and 3) to investigate the relationship between the degree of depot adherence and admission rate to hospital.

Methods:

Patients treated with depot antipsychot-ics were sampled from CCT settings in two AMHSs in urban Melbourne. Depot adherence was defined as patients receiving their injection ± 7 days from the due injection date. Sociodemographic data were acquired from relevant administrative databases.

Results:

The study finds that there is a high mean adherence rate (93%) and the rate of complete adherence is 54%. Patients' adherence was not related to gender, being subject to a CTO, being of NESB, long durations of illness or time on depot treatment. Twenty-eight per cent were admitted in the study year and admission was significantly inversely proportional to depot adherence. The risks of readmission increase significantly when patients are less than 85% adherent, having a relative risk of readmission of 2.63, and for those with less than 75% adherence, a relative risk of 4.32 (P < 0.01).

Conclusions:

To our knowledge, this is the first study to report on the FDAR in community-treated patients. The finding that below 85% adherence, readmission is significantly more likely suggests that there may be a role for carefully and progressively monitoring depot adherence in community services. Reduction in relapses from enhanced adherence will have clinical, social and economic benefits.