A retrospective study of the impact of antipsychotic medication on readmission in patients followed by a domiciliary care unit

Introduction Domiciliary care services’ patients have severe psychiatric disorders, challenging social contexts and physical comorbidities. These influence outcome but are difficult to modify. Conversely, antipsychotic medication is changeable and has been shown to be related to number of readmissions and length of stay. Objectives To assess whether injectable or oral and first or second generation antipsychotics (FGAP and SGAP) are associated with readmission and contact with mental health services. Aims To improve the quality of care in our domiciliary care unit (PreTrarCa) and its efficacy. Methods Active patients in PreTrarCa in 2015 with schizophrenia, schizoaffective, delusional or bipolar disorders were included ( n  = 64). Information regarding medication and average number of hospitalizations, appointments and missed appointments per year was retrospectively collected. Results Patients were mostly male (37), with mean age of 54, and mean follow-up of 41.20 months; 23 were prescribed injectable antipsychotics alone, 21 oral antipsychotics alone and 20 both; 36 were on injectable FGAP and 7 on SGAP. Oral medication was significantly related with missed appointments per year, but not with number of actual appointments. No other significant relation was found; although patients on SGAP had more hospitalizations (0.9 vs. 0.3 per year) and longer length of stay (21.9 vs. 6.3 days) these differences were not statistically significant. Conclusion Type of antipsychotic was not associated with readmission rates or contact with mental health services. Confounding variables and clinical outcome measures were not included and the effect of medication changes during follow up was not addressed.