In the RLAI group, 36 patients started treatment in the community and 54 as inpatients (including 37 who commenced treatment during a compulsory admission). The most common reason for starting RLAI was non-compliance with oral antipsychotic medication. The antipsychotic that preceded RLAI was atypical oral (57% of patients), conventional depot (39% of patients), clozapine (3% of patients) and no medication (1% of patients).
The total number of admissions fell from:
65 in the pre-RLAI phase to 33 in the RLAI phase in the total mirror-image group, (n=74);
53 to 21 when TR patients were excluded;
45 to 28 when AOT patients were excluded; and
38 to 18 when TR and/or AOT patients were excluded.
The reduction in all groups was statistically significant, (p<0.005 or p<0.05 when TR cases where excluded).
The total number of compulsory admissions fell from:
43 in the pre-RLAI phase to 12 in the RLAI phase in the total mirror-image group;
38 to 8 when TR patients were excluded;
28 to 11 when AOT patients were excluded; and
26 to 8 when TR and/or AOT patients were excluded, (p<0.005 for all cases).
The total days of inpatient stay fell from:
4,550 in the pre-RLAI phase to 2,188 in the RLAI phase in the total mirror-image group;
4,065 to 1,491 when TR patients were excluded;
3,254 to 2,042 when AOT patients were excluded; and
3,026 to 1,415 when TR and/or AOT patients were excluded.
All these differences where statistically significant, except for the case where only TR cases were excluded, (p=0.069).
In the RLAI group, no adverse effects were present in one third of patients, one third had no record of the presence or absence of adverse effects, and one third recorded an adverse effect attributed to RLAI (the most common being a movement disorder).
Almost 50% of RLAI patients discontinued therapy by the evaluation point, with 24 discontinuations occurring on an inpatient basis. The main reason for discontinuation was lack of efficacy, which accounted for approximately twice as many discontinuations as intolerability. Of the discontinued patients, 20.5% subsequently started clozapine.
For the sample of 90 RLAI patients, the median duration of treatment (measured from first injection to last injection) was 9.5 months (mean 12.2; range: 0.5 to 35.0).