{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:04:21Z","timestamp":1789718661606,"version":"4.0.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Partenariat Innovation-Qu\u00e9bec-Janssen (PIQJ) administered by the Quebec Health Research Funds"},{"name":"CR-IUSMM"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate changes in antipsychotic treatment patterns and healthcare utilization before and after initiation of long-acting injectable antipsychotics (LAI-APs) in a large Qu\u00e9bec population cohort, comparing individuals with schizophrenia (SCZ) to those with other psychotic disorders (non-SCZ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using linked Qu\u00e9bec administrative databases (RAMQ, MED-ECHO, and public drug insurance) to identify 6,221 adults who initiated a LAI-AP between April 2013 and December 2016, after a 12-month LAI-free period. Participants were followed for 12 months before and after the index date. The cohort was stratified into SCZ and non-SCZ, and were further divided by regimen at initiation (LAI only; LAI + clozapine; LAI + other oral antipsychotic). Antipsychotic exposure and health-service usage (hospitalizations, emergency visits, outpatient and community care) trajectories were analyzed weekly using state-sequence analysis; pre- versus post-initiation comparisons used paired statistical tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 6,221 patients (63.4% male; mean age 41.6 years), initial treatments consisted of paliperidone LAI (55.7%), aripiprazole LAI (21.5%), risperidone LAI (6.9%), first-generation LAI (15.6%), and LAI combinations (0.2%); 40% received LAI only, 5% LAI + clozapine, 55% LAI + an oral antipsychotic. SCZ patients were more often male, economically disadvantaged, and more likely to receive clozapine. After LAI initiation, hospital days fell sharply by almost 70% and outpatient and community-care visits increased substantially. Use of oral antipsychotics decreased overall post-initiation, except for clozapine (which rose) and first-generation oral drugs (which remained stable).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real-world Qu\u00e9bec cohort, LAI-AP initiation was followed by a marked reduction in hospitalizations and a shift toward outpatient and community care, regardless of diagnosis. Observed differences in sociodemographic and clinical profiles between SCZ and non-SCZ patients\u2014and among SCZ treatment subgroups\u2014suggest the need for tailored care pathways. These findings support LAI-AP effectiveness in reducing healthcare utilization and inform resource planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437261462697","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:29:38Z","timestamp":1782739778000},"page":"792-805","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare Pattern of Use Before and After Initiating a Long-Acting Antipsychotic Among a Cohort of 6221 Patients With a History of Psychosis"],"prefix":"10.1177","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2859-2100","authenticated-orcid":false,"given":"Emmanuel","family":"Stip","sequence":"first","affiliation":[{"name":"Universite de Montreal Faculte de medecine"},{"name":"Department of Psychiatry and Behavioral Science, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josiane","family":"Courteau","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine et des sciences de la sant\u00e9, Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7755-9043","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Brodeur","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Centre de Recherche CERVO, Universit\u00e9 Laval, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohann M.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine et des sciences de la sant\u00e9, Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke, Canada"},{"name":"D\u00e9partement de m\u00e9decine de famille et de m\u00e9decine d\u2019urgence, Universit\u00e9 de Sherbrooke, Sherbrooke, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9e","family":"Fleury","sequence":"additional","affiliation":[{"name":"Institut universitaire en sant\u00e9 mentale, Universit\u00e9 McGill, Montr\u00e9al, Canada"},{"name":"D\u00e9partement de Psychiatrie, Universit\u00e9 McGill, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Lesage","sequence":"additional","affiliation":[{"name":"Universite de Montreal Faculte de medecine"},{"name":"Centre de Recherche, Institut universitaire en sant\u00e9 mentale de Montr\u00e9al (IUSMM), Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0123-6651","authenticated-orcid":false,"given":"Marc-Andr\u00e9","family":"Roy","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Centre de Recherche CERVO, Universit\u00e9 Laval, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20972"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01997-8"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13r08440"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.38358"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.1322"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbad089"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-024-03075-6"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-023-02175-z"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2045125320957118"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/2045125318782694"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.16lr11402"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.16lr11401"},{"issue":"3","key":"e_1_3_2_14_2","article-title":"Impact of switching to long-acting injectable antipsychotics on health services use in the treatment of schizophrenia","volume":"60","author":"Lachaine J","year":"2015","unstructured":"Lachaine J, Lapierre ME, Abdalla N, Rouleau A, Stip E. 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