Predictors of Aripiprazole Treatment Continuation in Hospitalized Patients
J Clin Psychiatry 2008;69:1393-1397
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Aripiprazole is a second-generation antipsychotic
that is increasingly prescribed in a variety of psychiatric disorders. The goal
of this study was to investigate patient and treatment factors associated with
aripiprazole treatment continuation on hospital discharge in psychiatric
Method: This was a retrospective cohort analysis of patients
admitted to a psychiatric hospital between January 1, 2003, and June 30, 2006,
and treated with aripiprazole. The goal was to determine factors associated
with continuation of aripiprazole throughout the hospital stay and on discharge
from the hospital. Covariates assessed included patient demographics, prior
psychiatric hospitalizations, diagnoses, prior antipsychotic use, and
concomitant psychotropic medications. Aripiprazole-specific covariates were
starting and maximum dose and dose titration pattern. Diagnoses were identified
using ICD-9-CM codes.
Results: There were 1957 aripiprazole-treated patients
included in this study, and 1573 (80%) continued aripiprazole treatment at the
time of hospital discharge. Median starting doses were lower (5 mg/day) for
younger and older patients, and patients with psychotic disorders received
higher doses than other patients. Approximately 58% of patients had at least 1
aripiprazole dose titration while hospitalized, and most (73%) of those
patients had a dose titration within 3 days of admission. Predictors of
treatment continuation in this broad patient population were younger age, a
diagnosis of bipolar or major depressive disorder, higher maximum aripiprazole
doses, and upward dose titration within 3 days of admission. Patients receiving
concomitant anticholinergics or antipsychotics were less likely to continue
treatment as were those receiving aripiprazole at the time of hospitalization.
Conclusion: In this acute inpatient psychiatric setting,
continuation of aripiprazole treatment on discharge was achieved in most
patients. Demographic, diagnostic, and treatment factors predicting
aripiprazole treatment effectiveness were identified.