Enhanced treatment outcomes for schizophrenia through combined long-acting injectable antipsychotic medications and home visits: retrospective cohort study.

BACKGROUND

Long-acting injectable antipsychotic medications (LAIs) are more beneficial than oral medications for people with schizophrenia. However, some individuals are unable to visit out-patient clinics due to their symptoms, resulting in missed monthly LAI injections and subsequent relapse. Home visits for administration of LAIs could potentially reduce treatment failure, but there are no comparative studies on their effectiveness.

AIMS: This study aims to evaluate whether home visit administration of LAIs, compared with the out-patient clinic, reduces treatment failure for those with schizophrenia.

METHOD: We conducted a retrospective cohort study using electronic medical records from Seijin Hospital. Patients diagnosed with schizophrenia and treated with LAIs during hospitalisation between 1 April 2020 and 31 March 2023 were included. Following discharge, patients were followed for 1 year, either under home visits or out-patient clinic visits. The primary outcome was defined as treatment failure, including psychiatric rehospitalisation, discontinuation of treatment or death. Multivariate Cox proportional hazards regression analysis was performed to evaluate treatment failure risks.

RESULTS

A total of 125 patients in the home visit group and 117 in the out-patient group were included. During the follow-up period, home visits significantly reduced the risk of treatment failure (hazard ratio 0.62, 95% CI 0.40-0.97). However, having two or more psychiatric hospitalisations (hazard ratio 2.32, 95% CI 1.28-4.37) and living alone following discharge (hazard ratio 1.77, 95% CI 1.07-2.86) were associated with significantly increased risk of treatment failure.

CONCLUSIONS

Home visits, compared with out-patient clinic care, significantly reduce treatment failure in individuals with schizophrenia undergoing LAI treatment.