Key clinical point: Long-acting injections (LAIs) of antipsychotics are more effective than oral antipsychotics for preventing readmission of patients with schizophrenia in real-world settings.

Major finding: LAIs decreased the readmission rate by 29% compared with oral antipsychotic medications; readmissions were reduced by 58% in patients with repeated admissions.

Study details: A retrospective analysis of data from 75,274 patients hospitalized with schizophrenia (132,028 episodes of admission).

Disclosures: The authors declared no conflicts of interest.

Commentary

Acute psychotic relapse can occur in people with schizophrenia, especially in situations where medication adherence is sub-optimal. In addition to the immediate personal and financial burden associated with relapse and readmission to hospital, repeated recurrence impacts disease progression and long-term functioning. Findings of this study from South Korea are in line with other recent data suggesting that long-acting injectable antipsychotic medications (LAI) can reduce relapse risk. Effects may be particularly profound in those with more frequent relapse histories. The authors of this report emphasize the “real-world” aspect of their study in contrast to clinical trials where patients may be more motivated to seek care and engage with and adhere to treatment. Given the practical difficulties in assessing adherence levels among people with schizophrenia, recurrence and relapse may be good indicators that an individual is a good candidate for LAI consideration.—Martha Sajatovic, MD, Professor of Psychiatry and of Neurology; Willard Brown Chair in Neurological Outcomes Research; Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center; Case Western Reserve University School of Medicine.