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    Association of the First Antipsychotic Treatment Duration With the Re-Initiation of Treatment in Schizophrenia: A National Health Insurance Data-Based Study

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    https://www.riss.kr/link?id=A107882821

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Objectives: The optimal duration of maintenance treatment for patients with first-episode schizophrenia (FES) remains unclear.
    We examined the first antipsychotic treatment duration and its association with re-initiation of treatment using a nationwide claim database.
    Methods: Data from the Health Insurance Review and Assessment Service database in South Korea for 2007–2016 were used.
    Linear regression analysis and Cox proportional hazard models were used to evaluate the associations between the duration of the first antipsychotic treatment, time to re-initiation of treatment, and occurrence of treatment re-initiation.
    Results: Of 30,143 patients with FES, 80.4% (n=24,231) received <2 years of the first antipsychotic treatment. In patients who discontinued treatment (n=23,030), the rate of treatment re-initiation was 74.2% (n=17,086). As the duration of the first antipsychotic treatment increased, the time to re-initiation of treatment decreased (β=-0.146, p<0.001); however, the rate of treatment reinitiation was relatively constant (hazard ratio=1.001, p<0.001).
    Conclusion: Long-term antipsychotic treatment was not significantly associated with the rate of treatment re-initiation but showed a negative association with the time to re-initiation of treatment. Further research is needed to better understand the optimal treatment duration for FES.
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    Objectives: The optimal duration of maintenance treatment for patients with first-episode schizophrenia (FES) remains unclear. We examined the first antipsychotic treatment duration and its association with re-initiation of treatment using a nationwid...

    Objectives: The optimal duration of maintenance treatment for patients with first-episode schizophrenia (FES) remains unclear.
    We examined the first antipsychotic treatment duration and its association with re-initiation of treatment using a nationwide claim database.
    Methods: Data from the Health Insurance Review and Assessment Service database in South Korea for 2007–2016 were used.
    Linear regression analysis and Cox proportional hazard models were used to evaluate the associations between the duration of the first antipsychotic treatment, time to re-initiation of treatment, and occurrence of treatment re-initiation.
    Results: Of 30,143 patients with FES, 80.4% (n=24,231) received <2 years of the first antipsychotic treatment. In patients who discontinued treatment (n=23,030), the rate of treatment re-initiation was 74.2% (n=17,086). As the duration of the first antipsychotic treatment increased, the time to re-initiation of treatment decreased (β=-0.146, p<0.001); however, the rate of treatment reinitiation was relatively constant (hazard ratio=1.001, p<0.001).
    Conclusion: Long-term antipsychotic treatment was not significantly associated with the rate of treatment re-initiation but showed a negative association with the time to re-initiation of treatment. Further research is needed to better understand the optimal treatment duration for FES.

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    참고문헌 (Reference)

    1 Dans AL, "Users’ guides to the medical literature: XIV. how to decide on the applicability of clinical trial results to your patient" 279 : 545-549, 1998

    2 Kane JM, "Treatment strategies to prevent relapse and encourage remission" 68 (68): 27-30, 2007

    3 김지애, "Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data" 대한의학회 32 (32): 718-728, 2017

    4 De Hert M, "The use of continuous treatment versus placebo or intermittent treatment strategies in stabilized patients with schizophrenia : a systematic review and meta-analysis of randomized controlled trials with first-and second-generation antipsychotics" 29 : 637-658, 2015

    5 Emsley R, "The nature of relapse in schizophrenia" 13 : 50-, 2013

    6 McCreadie RG, "The Scottish first episode schizophrenia study:VII. two-year follow-up" 80 : 597-602, 1989

    7 Emsley R, "Symptom recurrence following intermittent treatment in first-episode schizophrenia successfully treated for 2 years : a 3-year open-label clinical study" 73 : e541-e547, 2012

    8 Murray RM, "Should psychiatrists be more cautious about the longterm prophylactic use of antipsychotics?" 209 : 361-365, 2016

    9 McGrath J, "Schizophrenia: a concise overview of incidence, prevalence, and mortality" 30 : 67-76, 2008

    10 Alvarez-Jimenez M, "Risk factors for relapse following treatment for first episode psychosis : a systematic review and meta-analysis of longitudinal studies" 139 : 116-128, 2012

    1 Dans AL, "Users’ guides to the medical literature: XIV. how to decide on the applicability of clinical trial results to your patient" 279 : 545-549, 1998

    2 Kane JM, "Treatment strategies to prevent relapse and encourage remission" 68 (68): 27-30, 2007

    3 김지애, "Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data" 대한의학회 32 (32): 718-728, 2017

    4 De Hert M, "The use of continuous treatment versus placebo or intermittent treatment strategies in stabilized patients with schizophrenia : a systematic review and meta-analysis of randomized controlled trials with first-and second-generation antipsychotics" 29 : 637-658, 2015

    5 Emsley R, "The nature of relapse in schizophrenia" 13 : 50-, 2013

    6 McCreadie RG, "The Scottish first episode schizophrenia study:VII. two-year follow-up" 80 : 597-602, 1989

    7 Emsley R, "Symptom recurrence following intermittent treatment in first-episode schizophrenia successfully treated for 2 years : a 3-year open-label clinical study" 73 : e541-e547, 2012

    8 Murray RM, "Should psychiatrists be more cautious about the longterm prophylactic use of antipsychotics?" 209 : 361-365, 2016

    9 McGrath J, "Schizophrenia: a concise overview of incidence, prevalence, and mortality" 30 : 67-76, 2008

    10 Alvarez-Jimenez M, "Risk factors for relapse following treatment for first episode psychosis : a systematic review and meta-analysis of longitudinal studies" 139 : 116-128, 2012

    11 Wyatt RJ, "Research in schizophrenia and the discontinuation of antipsychotic medications" 23 : 3-9, 1997

    12 Gaebel W, "Relapse prevention in first-episode schizophrenia : maintenance vs intermittent drug treatment with prodromebased early intervention : results of a randomized controlled trial within the German Research Network on Schizophrenia" 72 : 205-218, 2011

    13 Lieberman JA, "Psychobiologic correlates of treatment response in schizophrenia" 14 : 13S-21S, 1996

    14 Robinson D, "Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder" 56 : 241-247, 1999

    15 Takeuchi H, "One-year symptom trajectories in patients with stable schizophrenia maintained on antipsychotics versus placebo : meta-analysis" 211 : 137-143, 2017

    16 Haddad PM, "Nonadherence with antipsychotic medication in schizophrenia : challenges and management strategies" 5 : 43-62, 2014

    17 Newcomer JW, "Metabolic considerations in the use of antipsychotic medications : a review of recent evidence" 68 (68): 20-27, 2007

    18 Hui CLM, "Long-term effects of discontinuation from antipsychotic maintenance following first-episode schizophrenia and related disorders: a 10 year follow-up of a randomised, double-blind trial" 5 : 432-442, 2018

    19 Sadock BJ, "Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry" Wolters Kluwer 2015

    20 Barkhof E, "Interventions to improve adherence to antipsychotic medication in patients with schizophrenia: a review of the past decade" 27 : 9-18, 2012

    21 Gardner DM, "International consensus study of antipsychotic dosing" 167 : 686-693, 2010

    22 Sampson S, "Intermittent drug techniques for schizophrenia" CD006196-, 2013

    23 Lieberman JA, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia" 353 : 1209-1223, 2005

    24 Fenton WS, "Determinants of medication compliance in schizophrenia : empirical and clinical findings" 23 : 637-651, 1997

    25 Gitlin M, "Clinical outcome following neuroleptic discontinuation in patients with remitted recent-onset schizophrenia" 158 : 1835-1842, 2001

    26 Bostwick JR, "Antipsychotic-induced hyperprolactinemia" 29 : 64-73, 2009

    27 Shimomura Y, "Antipsychotic treatment in the maintenance phase of schizophrenia : an updated systematic review of the guidelines and algorithms" 215 : 8-16, 2020

    28 Boonstra G, "Antipsychotic prophylaxis is needed after remission from a first psychotic episode in schizophrenia patients : results from an aborted randomised trial" 15 : 128-134, 2011

    29 Leucht S, "Antipsychotic drugs versus placebo for relapse prevention in schizophrenia : a systematic review and meta-analysis" 379 : 2063-2071, 2012

    30 Tiihonen J, "20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia" 175 : 765-773, 2018

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