Relationship between response to aripiprazole once-monthly and paliperidone palmitate on work readiness and functioning in schizophrenia: A post-hoc analysis of the QUALIFY study

PLoS One. 2017 Aug 24;12(8):e0183475. doi: 10.1371/journal.pone.0183475. eCollection 2017.

Abstract

Schizophrenia is a chronic disease with negative impact on patients' employment status and quality of life. This post-hoc analysis uses data from the QUALIFY study to elucidate the relationship between work readiness and health-related quality of life and functioning. QUALIFY was a 28-week, randomized study (NCT01795547) comparing the treatment effectiveness of aripiprazole once-monthly 400 mg and paliperidone palmitate once-monthly using the Heinrichs-Carpenter Quality-of-Life Scale as the primary endpoint. Also, patients' capacity to work and work readiness (Yes/No) was assessed with the Work Readiness Questionnaire. We categorized patients, irrespective of treatment, by work readiness at baseline and week 28: No to Yes (n = 41), Yes to Yes (n = 49), or No at week 28 (n = 118). Quality-of-Life Scale total, domains, and item scores were assessed with a mixed model of repeated measures. Patients who shifted from No to Yes in work readiness showed robust improvements on Quality-of-Life Scale total scores, significantly greater than patients not ready to work at week 28 (least squares mean difference: 11.6±2.6, p<0.0001). Scores on Quality-of-Life Scale instrumental role domain and items therein-occupational role, work functioning, work levels, work satisfaction-significantly improved in patients shifting from No to Yes in work readiness (vs patients No at Week 28). Quality-of-Life Scale total scores also significantly predicted work readiness at week 28. Overall, these results highlight a strong association between improvements in health-related quality of life and work readiness, and suggest that increasing patients' capacity to work is an achievable and meaningful goal in the treatment of impaired functioning in schizophrenia.

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use*
  • Aripiprazole / administration & dosage
  • Aripiprazole / therapeutic use*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Employment*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paliperidone Palmitate / administration & dosage
  • Paliperidone Palmitate / therapeutic use*
  • Schizophrenia / drug therapy*
  • Schizophrenia / physiopathology

Substances

  • Antipsychotic Agents
  • Aripiprazole
  • Paliperidone Palmitate

Grants and funding

This work was supported by H. Lundbeck A/S and Otsuka Pharmaceutical Development & Commercialization, Inc. Authors Forray C, Sapin C, Beillat M, Nylander AG, Hertel P, Schmidt SN, Ettrup A, Eramo A, and Hansen K are employed by H. Lundbeck A/S; authors Baker RA and Peters-Strickland T are employed by Otsuka Pharmaceutical Development & Commercialization, Inc.; and author Loze JY is employed by Otsuka Pharmaceutical Europe Ltd. The specific roles of these authors are articulated in the 'author contributions' section. The funders provided support in the form of salaries for these authors, and were involved in the study design, data collection and analysis, the decision to publish, and preparation of the manuscript.