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Patients with schizophrenia are generally at high risk of readmission. More than a half of patients was readmitted within 10 years. Patients with schizophrenia often refuse to take oral antipsychotics what leads to the reoccurrence of symptoms and rehospitalization. The purpose of this paper is to propose a research analyzing the frequency of admission rates among patients with schizophrenia treated with long-acting injectable antipsychotics or with oral antipsychotics. The hypothesis of the research will be that treatment with long-acting antipsychotics leads to lower readmission rates than treatment with oral antipsychotics.
The readmission rates among patients with schizophrenia are very high. According to Chi et al. (2016), “570 (70.5%) patients were readmitted within 10 years; the median time between admissions was 1.9 years, and 25% of subjects were readmitted within 4 months of the first hospitalization” (184). Remarkably, these rates were not influenced by age, gender, or length of hospitalization of patients. These results allow concluding that the main difference between readmission and non-readmission groups of patients is the type of their treatment.
There are two main types of treatment for patients with schizophrenia: long-acting injectable antipsychotics and oral antipsychotics (Chou, Reome, & Davis, 2016). After being discharged from a hospitalization, patients act on their own and do not receive compulsive medication.
They should take oral antipsychotics that help them to eliminate symptoms and maintain their stable condition. Nevertheless, it is very hard for patients with schizophrenia to follow the medication plan because they often suffer distortions of reality and think in a disorganized way. Therefore, the hypothesis of this research will be that patients treated with long-acting injectable antipsychotics show lower readmission rates.
The comparison of readmission rates between patients treated with long-acting injectable antipsychotics and oral antipsychotics calls for the detailed analysis of statistics. Therefore, the current research will be of the quantitative design. According to the chosen research design researcher will use non-probability purposive sampling to find records about patients of particular groups according to the type of treatment.
The analysis of selected records from hospital databases should be limited by the age of patients, the nature of their hospitalization, and the type of treatment. According to the research by MacEwan et al. (2016), “Medical claims of patients with schizophrenia who were ages 18–64 and had a first hospitalization for a serious mental illness (index hospitalization, October 2007 through September 2012) and at least one prescription for a first- or second-generation antipsychotic were analyzed from the Truven Health MarketScan Multi-State Medicaid Database” (p. 1184). This example shows good stratification of analyzed medical records.
For the purposes of the research, the patients should not be too young and too old, the description of their first hospitalization should present symptoms of schizophrenia, and their treatment should include the use of antipsychotics. For the exhaustive representation of the statistics, the sample size should include records covering cases of schizophrenia within 10 years to trace the development of antipsychotics of both types and their influence on the readmission rates (Busch, Epstein, McGuire, Normand, & Frank, 2015). The findings may be generalized to all people with schizophrenia treated with oral antipsychotics or long-acting injectable antipsychotics. Differences in the patient behavior present limitation to the generalizability of results.
The current paper proposed a research on the difference in readmission rates between patients with schizophrenia treated with oral antipsychotics or long-acting injectable antipsychotics. The proposed research used quantitative design and non-probability purposive sampling. The researcher selected the sample from hospital medical records about patients with schizophrenia. The sample was limited according to the age of patients, their symptoms during the first hospitalization, and the type of treatment.
References
Busch, A. B., Epstein, A. M., McGuire, T. G., Normand, S. L. T., & Frank, R. G. (2015). Thirty day hospital readmission for medicaid enrollees with schizophrenia: The role of local health care systems. The Journal of Mental Health Policy and Economics, 18(3), 115.
Chi, M. H., Hsiao, C. Y., Chen, K. C., Lee, L. T., Tsai, H. C., Lee, I. H.,… & Yang, Y. K. (2016). The readmission rate and medical cost of patients with schizophrenia after first hospitalization—A 10-year follow-up population-based study. Schizophrenia Research, 170(1), 184-190.
Chou, F., Reome, E., & Davis, P. (2016). Impact on length of stay and readmission rates when converting oral to long-acting injectable antipsychotics in schizophrenia or schizoaffective disorder. Mental Health Clinician, 6(5), 254-259.
MacEwan, J. P., Kamat, S. A., Duffy, R. A., Seabury, S., Chou, J. W., Legacy, S. N.,… & Karson, C. (2016). Hospital readmission rates among patients with schizophrenia treated with long-acting injectables or oral antipsychotics. Psychiatric Services, 67(11), 1183-1188.
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