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Psych Congress  

Evaluating medication adherence by treatment failure event with paliperidone palmitate vs oral antipsychotic therapy in subjects with schizophrenia

Erik Muser, MS, PharmD
Larry Alphs, MD, PhD
Carmela Benson, MS
LIan Mao, PhD
HL Starr, MD, FAAP
Janssen Scientific Affairs, LLC

ntroduction: This supplementary analysis of a randomized study (NCT01157351) evaluated surrogate measures of medication adherence after treatment initiation in subjects with schizophrenia with and without a treatment failure (TF) event (ie, an arrest/incarceration or psychiatric hospitalization). Methods: 444 subjects with schizophrenia were randomly assigned to paliperidone palmitate (PP) or to 1 of 7 oral antipsychotics (OAs). Medication adherence was evaluated using medication possession ratio (MPR) for all randomly assigned subjects who received ≥1 dose of treatment (PP, n=226; OA, n=218). Subjects with MPR >80% were considered adherent. Injection logs for PP and clinician-based "prescribed" records and pharmacy-based "fill" records for OAs evaluated MPR. Additionally, MPR was evaluated by whether or not subjects had a TF. Results: 76/226 (33.6%) PP and 98/218 (45.0%) OA subjects had an event monitoring board-defined TF, whereas 150/226 (66.4%) PP and 120/218 (55.0%) OA subjects did not. Adherence was 95.2% for PP subjects per injection log vs 78.6% for OA subjects per prescribed records or 24.3% per pharmacy fill records. For subjects with a TF, 89.3% of PP subjects were adherent per injection log vs 68.5% and 20.3% for OA per prescribed and pharmacy fill records, respectively. For subjects without a TF, 98.5% of PP subjects per injection log were adherent vs 87.5% and 28.4% of OA subjects per prescribed and pharmacy fill records, respectively. Conclusions: A higher percentage of PP subjects appeared adherent vs OA subjects, and those without a TF appeared more adherent than those with a TF.

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