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Table 2 Demographic and clinical characteristics evaluated during the 12-month baseline period in unweighted and IPT-weighted overall cohorts

From: Adherence, healthcare resource utilization and Medicaid spending associated with once-monthly paliperidone palmitate versus oral atypical antipsychotic treatment among adults recently diagnosed with schizophrenia

 

Overall cohort

Unweighted

IPT-weighted

PP1M (N = 2053)

OAA (N = 22,247)

Std. Diff. a

PP1M (N = 11,612)

OAA (N = 12,688)

Std. Diff. a

Age at index date (years), mean ± SD [median]

41.3 ± 12.6 [41.5]

43.9 ± 13.5 [45.0]

19.8%

42.9 ± 12.9 [43.6]

43.6 ± 13.4 [44.7]

5.1%

Female, %

39.2%

50.8%

23.6%

46.4%

49.6%

6.6%

Race, %

 White

49.5%

58.0%

17.0%

56.2%

57.1%

1.9%

 Black

41.6%

33.1%

17.5%

34.2%

33.9%

0.6%

 Hispanic

0.1%

0.2%

1.7%

0.3%

0.2%

1.7%

 Other

6.1%

6.1%

0.1%

6.5%

6.1%

1.4%

 Unknown

2.6%

2.6%

0.4%

2.8%

2.6%

1.5%

State, %

 Iowa

4.7%

6.6%

8.2%

7.2%

6.4%

3.2%

 Kansas

10.2%

7.6%

9.1%

8.1%

7.9%

0.8%

 Mississippi

12.3%

10.0%

7.4%

8.8%

10.2%

4.7%

 Missouri

50.4%

50.4%

0.1%

52.4%

50.4%

3.9%

 New Jersey

22.4%

25.4%

7.2%

23.5%

25.1%

3.7%

Region characteristics, %

 Urban

55.4%

56.2%

1.5%

55.4%

56.1%

1.4%

 Suburban

26.7%

26.3%

1.0%

25.8%

26.2%

0.9%

 Rural

17.9%

17.5%

0.9%

18.7%

17.7%

2.8%

Insurance eligibility, %

 Capitated or dual coverage

66.1%

66.7%

1.1%

67.1%

66.6%

1.2%

 Capitated

40.4%

41.5%

2.1%

41.9%

41.5%

1.0%

 Dual coverage

39.6%

39.9%

0.5%

40.4%

39.8%

1.3%

Year of index date, %

 2009

14.3%

12.4%

5.4%

9.9%

12.5%

8.3%

 2010

38.6%

37.1%

3.2%

34.1%

37.2%

6.3%

 2011

21.0%

23.8%

6.6%

21.7%

23.5%

4.3%

 2012

13.1%

14.5%

4.1%

17.7%

14.4%

9.0%

 2013

10.3%

9.5%

2.5%

13.0%

9.7%

10.4%

 2014

2.7%

2.7%

0.4%

3.5%

2.7%

4.8%

Quan-CCI, mean ± SD [median]

0.7 ± 1.3 [0.0]

1.1 ± 1.7 [1.0]

26.7%

1.0 ± 1.6 [1.0]

1.1 ± 1.7 [1.0]

5.4%

Number of unique mental health diagnoses, mean ± SD [median]

7.2 ± 7.0 [5.0]

8.4 ± 8.5 [6.0]

15.0%

8.7 ± 8.1 [6.0]

8.3 ± 8.4 [6.0]

4.6%

Number of unique AP agents received, mean ± SD [median]

1.7 ± 1.1 [2.0]

1.0 ± 1.1 [1.0]

65.5%

1.3 ± 1.2 [1.0]

1.1 ± 1.1 [1.0]

17.7%

AP use, %

87.8%

61.8%

62.8%

67.9%

64.2%

8.0%

 Typical oral and short-term injectable

24.2%

22.4%

4.2%

27.0%

22.8%

9.9%

 Atypical oral and short-term injectable

65.7%

49.6%

33.0%

54.9%

51.0%

7.7%

 Typical LAI

17.4%

6.0%

36.2%

8.5%

7.2%

4.9%

 Atypical LAI

36.7%

5.3%

83.4%

9.1%

8.3%

2.8%

Proportion of days covered (PDC) by any AP agent, %

 PDC < 0.8b

64.3%

67.2%

6.2%

67.2%

66.9%

0.7%

 PDC ≥ 0.8b

35.7%

32.8%

6.2%

32.8%

33.1%

0.7%

AP polypharmacy presentc, %

22.9%

10.9%

32.6%

14.4%

12.1%

7.0%

Other psychiatric medication use, %

71.7%

76.8%

11.6%

75.2%

76.6%

3.1%

 Antidepressants

50.1%

57.0%

13.9%

55.4%

56.4%

2.1%

 Anxiolytics

40.1%

50.3%

20.6%

50.0%

49.4%

1.1%

 Mood stabilizers

40.3%

41.0%

1.5%

42.9%

41.1%

3.6%

Number of unique psychiatric agents receivedd, mean ± SD [median]

3.6 ± 2.4 [3.0]

3.3 ± 2.6 [3.0]

11.3%

3.4 ± 2.7 [3.0]

3.3 ± 2.6 [3.0]

4.6%

Psychiatric polypharmacy presente, %

44.5%

37.2%

14.9%

39.6%

38.1%

3.0%

Specific comorbidities presentf, %

 Cardiovascular diseaseg

11.2%

18.3%

20.1%

15.6%

17.6%

5.6%

 Diabetes

20.5%

24.0%

8.6%

23.1%

23.7%

1.5%

 Obesity

9.4%

10.4%

3.3%

12.9%

10.4%

7.9%

 Drug abuse

21.5%

19.9%

4.0%

21.2%

20.1%

2.8%

 Hepatitis Cg

3.4%

4.7%

6.6%

4.2%

4.5%

1.6%

 HIV/AIDS

1.3%

1.8%

4.3%

2.1%

1.8%

2.3%

Baseline monthly healthcare costs (2015 $US), mean ± SD [median]

 Total healthcare costs

$2050 ± $2848 [$1288]

$2230 ± $3883 [$1125]

5.3%

$2091 ± $3162 [$1098]

$2226 ± $3818 [$1154]

3.9%

  Total pharmacy costs

$510 ± $762 [$107]

$363 ± $677 [$54]

20.4%

$420 ± $746 [$47]

$372 ± $678 [$57]

6.7%

  Total medical costs

$1540 ± $2581 [$843]

$1867 ± $3727 [$783]

10.2%

$1671 ± $2855 [$777]

$1854 ± $3661 [$802]

5.6%

Baseline healthcare resource utilization, % with ≥1 visit/service

 Outpatient visits

91.1%

91.7%

2.2%

92.4%

91.7%

2.6%

  Number of visits per month, mean ± SD [median]

1.06 ± 1.54 [0.67]

1.33 ± 2.25 [0.83]

13.6%

1.22 ± 2.04 [0.75]

1.31 ± 2.22 [0.75]

4.3%

 Emergency room visits

48.4%

56.5%

16.2%

53.5%

56.0%

5.1%

  Number of visits per month, mean ± SD [median]

0.16 ± 0.49 [0.00]

0.20 ± 0.56 [0.08]

7.4%

0.19 ± 0.51 [0.08]

0.20 ± 0.56 [0.08]

2.1%

 Inpatient visits

46.7%

54.2%

15.2%

55.9%

53.9%

3.9%

  Number of visits per month, mean ± SD [median]

0.11 ± 0.28 [0.00]

0.13 ± 0.26 [0.08]

7.7%

0.13 ± 0.25 [0.08]

0.13 ± 0.26 [0.08]

0.4%

 Long-term care admissions

4.6%

8.3%

15.0%

6.9%

8.1%

4.7%

  Number of admissions per month, mean ± SD [median]

0.01 ± 0.04 [0.00]

0.02 ± 0.10 [0.00]

12.6%

0.01 ± 0.05 [0.00]

0.02 ± 0.10 [0.00]

8.3%

 Mental health institute admissions

62.6%

39.5%

47.4%

51.4%

41.3%

20.5%

  Number of admissions per month, mean ± SD [median]

0.73 ± 1.18 [0.17]

0.36 ± 0.86 [0.00]

35.5%

0.45 ± 0.91 [0.08]

0.40 ± 0.90 [0.00]

5.5%

 One-day mental health institute admissions

72.0%

53.2%

39.6%

61.1%

54.6%

13.1%

  Number of admissions per month, mean ± SD [median]

1.28 ± 1.47 [0.75]

0.70 ± 1.16 [0.08]

43.7%

0.81 ± 1.18 [0.25]

0.76 ± 1.21 [0.08]

4.0%

 Home care

33.9%

37.0%

6.4%

35.8%

36.9%

2.2%

  Number of services per month, mean ± SD [median]

0.76 ± 2.73 [0.00]

1.10 ± 3.92 [0.00]

10.2%

0.85 ± 3.19 [0.00]

1.09 ± 3.88 [0.00]

6.9%

 Other services

34.3%

33.5%

1.8%

32.2%

33.3%

2.3%

  Number of services per month, mean ± SD [median]

0.12 ± 0.32 [0.00]

0.13 ± 0.41 [0.00]

3.8%

0.11 ± 0.29 [0.00]

0.13 ± 0.41 [0.00]

6.4%

  1. AP antipsychotics, CCI Charlson comorbidity index, IPT inverse probability of treatment, LAI long-acting injectable therapy, OAA oral atypical antipsychotics, PDC proportion of days covered, PP1M once-monthly paliperidone palmitate
  2. aBaseline characteristics with a standardized difference <10% were considered well balanced. For continuous variables, the standardized difference is calculated by dividing the absolute difference in means of the PP1M and the OAA cohorts by the pooled standard deviation of both groups. The pooled standard deviation is the square root of the average of the squared standard deviations. For categorical variables with 2 levels, the standardized difference is calculated using the following equation where P is the respective proportion of participants in each group: (PPP1M-POAA)/√[p(1-p)], where p = (PPP1M + POAA)/2
  3. bThe denominator for the proportion of patients with a PDC <0.8 or a PDC ≥0.8 is the number of patients with a PDC >0
  4. cAP polypharmacy is defined as having overlapping coverage of ≥2 unique AP agents for at least 60 consecutive days with no gaps larger than 7 days
  5. dIncludes: mood stabilizers, anxiolytics, antidepressants, and antipsychotics
  6. ePsychiatric polypharmacy is defined as having overlapping coverage of ≥1 AP agent and ≥1 anxiolytic, antidepressant, or mood stabilizer for at least 60 consecutive days with no gaps larger than 7 days.
  7. fReference: Elixhauser A, Steiner C, Kruzikas. D. HCUP Methods Series Report # 2004–1. ONLINE February 6, 2004. U.S. Agency for Healthcare Research and Quality. [Internet]. Comorbidity Software Documentation. Rockville, MD, USA; 2004 [cited 2013]. p. 12–5. Available from: http://www.hcup-us.ahrq.gov/reports/ComorbiditySoftwareDocumentationFinal.pdf
  8. gCardiovascular disease was defined using ICD-9-CM codes: 410.xx, 411.0×, 411.81, 411.89, 411.1×, 413.xx, 427.5×, 427.1×, 427.4×, 427.3×, 398.91, 428.xx, 414.0×, 414.1×, 414.8×, 414.9×, 429.3×, 402.9×, 430.xx, 431.xx, 432.xx, 433.xx, 434.xx, 435.xx, 436.xx, 437.xx, 427.89; hepatitis C were defined using the ICD-9 codes: 070.41, 070.44, 070.51, 070.54, 070.7×, V02.62
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BMC Psychiatry

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