Hospital utilization rates following antipsychotic dose reduction in mood disorders: implications for treatment of tardive dyskinesia

摘要

Sample selection for the BD and MDD groups. Patients were selected for case and control cohorts from a Medicaid claims database representing six US states and the most recent 6 years of data as detailed in Methods. BD: bipolar disorder; ICD-9/10: International Classification of Diseases, 9th/10th Revision; MDD: major depressive disorder. 1Diagnoses for BD were based on ICD-9 codes 296.0x, 296.1x, 296.4x, 296.5x, 296.6x, 296.7x, or 296.8x; and ICD-10 codes F30.x and F31.x from the Medicaid claims database (the most recent 6 years for data of each state). 2Diagnoses for MDD were based on ICD-9 codes 296.2x and 296.3x; and ICD-10 codes F32.x and F33.x from the Medicaid claims database (the most recent 6 years for data of each state). 3Cases were defined as patients at a stable monotherapy dose for a ≥ 90-day period and then experienced an ≥10% dose reduction during the same monotherapy period. The first prescription date for the dose reduction fill was defined as a dose reduction starting date and was a potential index date. 4Controls were defined as patients who did not have a dose reduction and who had a stable dose monotherapy period that lasted for ≥91 days. The first prescription fill after the first 90 days of this stable dose monotherapy period was defined as a potential index date. 5Exclusion was based on dual eligibility for Medicare and Medicaid and the inability to capture drug claim information through Medicare claims. 6Cases were not included in the subsequent analysis if they could not be adequately matched on all of the matching characteristics, including: age, sex, type of health plan, state, index drug (first- vs second-generation antipsychotic), and index year