An evaluation of inpatient treatment continuation and hospital readmission rates in patients with bipolar disorder treated with aripiprazole or quetiapine

Abstract

Objective: The primary objective of this study was to assess patient and treatment variables that have an impact on inpatient antipsychotic treatment continuation and 30-day hospital readmission rates in patients with bipolar disorder treated with aripiprazole or quetiapine.

Methods: This was a retrospective cohort study of adult patients with bipolar disorder admitted to a psychiatric hospital. Patients who were initiated on aripiprazole or quetiapine during hospitalization were included in the analysis. The two groups were compared with regards to antipsychotic treatment continuation to discharge and 30-day hospital readmission rates using logistic regression analysis.

Results: A total of 336 patients were included in the study. No difference in inpatient antipsychotic treatment continuation rates to discharge were observed, with 85.3% and 84.9% of patients in the aripiprazole and quetiapine cohorts, respectively, continuing treatment with the index antipsychotic to discharge (p = 0.92). Logistic regression analysis revealed that patients were more likely to be prescribed their index antipsychotic at discharge if they were younger than 40 years of age (OR = 2.05, 95% CI =1.08-3.89) and/or diagnosed with a bipolar depressed (OR = 3.05, 95% CI = 1.05-8.85) or mixed episode (OR = 4.14, 95% CI = 1.24-13.87) compared with a manic episode. Patients treated with divalproex (OR = 0.49, 95% CI = 0.25-0.94) or a benzodiazepine (OR = 0.37, 95% CI = 0.18-0.75) at discharge were less likely to be prescribed the index antipsychotic at discharge. Continuation of the index antipsychotic to discharge did not have an impact on readmission rates; admissions during the year before the index hospitalization were the only predictor of 30-day readmission rates (OR = 2.44, 95% CI = 1.08-5.48).

Conclusion: No difference was observed in inpatient antipsychotic treatment continuation and 30-day hospital readmission rates in patients treated with either aripiprazole or quetiapine.