Wisdom, A.1, Cole, S.1, Ingole, A.2.  

1 Northern Adelaide LHN, SA Health, 2 Central Adelaide LHN, SA Health


Background: Paliperidone palmitate (Invega Trinza) is currently the only 3-monthly antipsychotic formulation approved for the treatment of schizophrenia. While clinical trials have demonstrated successful results, post-marketing data is limited.

Objectives: To assess rates of successful transition to the 3-monthly paliperidone injection, while exploring whether the longer dosing interval has an effect on consumer contact with mental health clinicians.

Methods: Community mental health consumers initiated on the 3-monthly paliperidone injection were followed for 6 months following their first 3-monthly injection.  Successful transition was defined as transition to the 3-monthly injection without one or more of the following events occurring within 6 months: hospital admission, additional or increased supplemental antipsychotic therapy, or change or cessation of the 3-monthly injection.

Findings: During the 6 months post transition 41 of 65 (63.1%) consumers successfully transitioned to the 3-monthly injection. Hospital admission was required for 8 (12.3%) consumers and 12 (18.5%) required increased or new antipsychotic supplementation. The 3-monthly injection was discontinued in 11 (16.9%) consumers including 7 (10.8%) who returned to the 1-monthly preparation. Consumers had fewer mean face-to-face contacts with clinicians compared to the 6 months prior to transition (8.2 vs 11.1, p<0.001). This was true for both medical (1.8 vs 2.3, p=0.01) and non-medical contacts (6.4 vs 8.8, p<0.01).

Conclusions: Challenges may be present when transitioning to a long acting antipsychotic injection with a longer dosing interval in a real world setting.  Dissemination of these findings to multi-disciplinary community teams is anticipated to increase purposeful engagement with consumers during this transition period.

Alice Wisdom

Alice is currently a Senior Pharmacist within the Northern Adelaide Local Health Network, working in Mental Health and Research.  Her areas of interest include promoting and sustaining quality use of medicines and expanding the role of pharmacists to improve patient care. Alice also has a special interest in research within the area of mental health. Alice has over 5 peer-reviewed publications and has presented her work at several national conferences. Within her research role, partnering with SA Pharmacy, Alice supports and promotes quality, innovative and collaborative research within NALHN.

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