{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:14:02Z","timestamp":1790824442482,"version":"4.1.0"},"reference-count":67,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to describe the utilization patterns of antipsychotic (AP) medication in patients with schizophrenia (SCZ), three years after initiating or reinitiating a given AP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on medico\u2010administrative information on patients living in Quebec (Canada), this retrospective cohort study included 6444 patients with a previous diagnosis of SCZ initiating or reinitiating AP medication between January 1, 2012, and December 31, 2014, with continuous coverage by public drug insurance. For each day of follow\u2010up (1092\u00a0days), patient was either exposed to one of the chosen categories of APs, or to none. This patient\u2019s sequence of AP exposure overtime has been referred to as the \u201cantipsychotic utilization trajectory\u201d. These trajectories were analyzed using a State Sequence Analysis, an innovative approach which provides useful visual information on the continuation and discontinuation patterns of use over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clozapine and long\u2010acting injectable second\u2010generation APs had the best continuation and discontinuation patterns over 3\u00a0years among all other groups, including less switching of APs, while oral first\u2010generation APs had the poorest patterns. These findings were comparable among incident and non\u2010incident cohorts. Oral second\u2010generation antipsychotics, excluding clozapine, had a poorer continuation and discontinuation pattern than long\u2010acting injectable antipsychotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>State Sequence Analysis provides a clear representation of treatment adherence in comparison with dichotomous indicators of adherence or discontinuation. Consequently, this innovative method has shed light on the impact of the AP chosen to initiate or reinitiate treatment in SCZ, which has been identified as a key factor for long\u2010term treatment continuation and discontinuation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.13411","type":"journal-article","created":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T04:39:26Z","timestamp":1644727166000},"page":"469-480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Antipsychotic utilization trajectories three years after initiating or reinitiating treatment of schizophrenia: A state sequence analysis approach"],"prefix":"10.1111","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7755-9043","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Brodeur","sequence":"first","affiliation":[{"name":"D\u00e9partement de Psychiatrie et Neurosciences Universit\u00e9 Laval Qu\u00e9bec QC 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