| Objectives: This study evaluated the clinical ef ficacy,recurrence rate,safety,improvement of social function and economic benefits of schizophrenia patients by injecting Paliperidone palmitate long-acting injection,regularly following up for 12 months,so as to improve the treatment compliance of s chizophrenics,effectively reduce and prevent relapse,reduce the hospitalization rate,improve the social function and the quality of life of patients,reduce the family and social economic burden,and provide treatment options for improving the long-term prognosis of schizophrenia.Methods: According to the inclusion and exclusion criteria,546 patients with schizophrenia who met the diagnostic criteria of the International Statistical Classification of Diseases 10 th Revision(ICD-10)were included in this study.General data and past psychiatric history were collected from patients enrolled.Positive and Negative Symptom Scale(PANSS),Brief Psychiatric Rating Scale(BPRS),Social Disability Screening Schedule(SDSS),Life Attitude Scale,Short Form 12 questionnaire(SF-12)Zarit Caregiver Burden Interview(ZBI),Treatment Emergency Symptom Scale(TESS),adverse event report form,Arizona Sexual Experience Scale(ASEX),risk assessment,patient and family treatment satisfaction questionnaire,laboratory ex amination,etc.were evaluated.Collect relevant information about the economic burden of patients before and after treatment in the 12 th month,that is,the direct economic burden includes direct medical expenses(outpatient expenses,hospitalization expenses)and direct non-medical expenses(transportation expenses,accommodation expenses and catering expenses paid for medical treatment),the indirect economic burden includes disease losses(economic losses caused by the reduction of working hours and wor king ability due to illness,economic costs caused by destructive behavior)and death losses.The number of outpatient visits and inpatients in the past year,and other information of the patients were analyzed to the efficacy,safety,recurrence rate,improvement of social function and economic benefits after treatment.The experimental results were statistically analyzed by SPSS26.0.Results: 1.The total score of PANSS,positive symptoms,negative symptoms,general psychopathological symptoms and BPRS at the 1st,3rd,6th,9th and 12 th months after treatment were significantly lower than those before treatment(P<0.05).2.The total scores of SDSS,SF-12 and Zarit Care Burden Scale at the 1st,3rd,6th,9th and 12 th months after treatment were significan tly lower th an those before treatment(P<0.05).3.The total score of ASEX at the 1st,3rd,6th,9th and 12 th months after treatment was significantly lower than that before treatment(P<0.05).4、 The total score of risk assessment at the 1st,3rd,6th,9 th and 12 th months after treatment was significantly lower than that before treatment(P<0.05).5、 There were 8(1.5%)and 2(0.4%)people who had suicidal ideas within 1 year in the 6th and 12 th months after treatment,which was significantly lower than the 30(5.5%)people before treatment.6.Comparison of treatment satisfaction: The satisfaction of patients and guardians at the 1st,3rd,6th,9th and 12 th months after treatment was significantly higher than that before treatment(P<0.05).7.After treatment,156 patients(33.99%,N=459)recurred in the first month,96 patients(24.06%,N=399)in the third month,54 patients(16.31%,N=331)in the sixth month,37 patients(13.55%,N=273)in the ninth month,and 30 patients(12.55%,N=239)in the twelfth month.The recurrence rate conti nued to decline.8.After treatment,the average number of outpatient visits per year increased compared with that before treatment,and the number of inpatient treatment decreased,with a statistically significant difference(P<0.05).9.The economic bu rden(direct economic burden and indirect economic burden)of the patients after treatment was significantly reduced compared with that before treatment,and the differe nce was statistically significant(P< 0.05).10.After 12 months of treatment,27 patients(5%)had anxiety,38 patients(7%)had insomnia,25 patients(4.6%)had headache,33 patients(6%)had tremor,16 patients(0.3%)could not sit still,8 patients(1.5%)had blurred vision,17 patients(3.2%)had nausea and vomiting,21 patients(3.8%)had constipation,29 patients(5.3%)had abnormal blood pressure,28 patients(5.2%)had tachycardia,and 22 patients(4%)had menstrual disorders;47 people(8.6%)gained weight after treatment;The QTc o f patients was(387.41 ± 2.63)ms,and there was no signifi cant difference compared with(374.03 ± 2.01)ms before treatment(P=0.16,>0.05);In the laboratory examination,29 people(5.3%)had elevated total cholesterol,31 people(5.7%)had elevated trigl yceride,and 18 people(3.3%)had elevated fasting blood glucose.11.Patients were divided into effective and ineffective groups based on whether they were effective after treatment(PANSS score reduction rate=(baseline score-visit point score)/(basel ine score-30)*%,with a score reduction rate of ≥ 25% indicating effectiveness and<25% indicating ineffectiveness).Univariate analysis results showed that education,smoking status,and concomitant oral antipsychotic drugs were significantly correlated with treatment effectiveness(P<0.05);The Cox regression analysis results showed that smoking and the combination of oral antipsychotic drugs were independent factors affecting the treatment effectiveness of patients.Smoking can reduce the treatment effe ctiveness of patients(HR=1.408,95% CI: 1.134~1.748,P=0.0 02),and oral antipsychotic drugs can improve the treatment effectiveness of patients(HR=0.797,95% CI: 0.647~0.980,P=0.032).Conclusions: 1.Paliperidone palmitate long-acting injection significa ntly improved the positive symptoms,negative symptoms,gen eral psychopathological symptoms of schizophrenia patients,and has lower risk and fewer adverse reacions.2.Paliperidone palmitate long-acting injection improves the social function and the quality of life of patients,and reduces the care burden of thei r main caregivers.3.Palipexone palmitate long-acting injection reduced the suicide concept of patients.4.Paliperidone palmitate long-acting injection improved the treatment satisfaction of patien ts and their guardians.5.Paliperidone palmitate long-acting injection improves the treatment compliance of patients,reduces the recurrence rate,the number of hospitalization,the waste of medical resources,the direct and economic burden of patients,wi th good economic benefits.6.Smoking 、 combined with oral antipsychotics is an independent influencing factor for the efficacy of paliperidone Palmitate Long acting Injection in the treatment of schizophrenia.Smoking can reduce the treatment efficiency of patients,while oral antipsych otic drugs can improve the treatment efficiency of patients. |
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