Caregiver Burden in Schizophrenia: Pooled Analysis of the Involvement Evaluation Questionnaire Data for Paliperidone Palmitate 3-Month Formulation

Schizophrenia-related caregiver burden is often under-recognized and associated with significant psychological and physical stress and increased indirect costs on the caregiver. The pooled analysis of 2 double-blind, randomized, multicenter, phase 3 studies (NCT01529515 and NCT01515423) evaluated the predictors of improvement or worsening of schizophrenia-related caregiver burden following paliperidone palmitate (including 1-month and 3-month formulations) treatment. Caregivers (family members/friends who had ≥1 hour of contact per week with the patients treated with PP 1-month) were offered to complete the involvement evaluation questionnaire (IEQ; 46 items; each item score: 0-4; total score: sum of all items in module 2 [0-124]). Total, 1497 caregivers (mean [SD] age: 51.5 [13.02] years) were included: 49.3% were parents and >50% of caregivers spent >32 hours/week in caregiving. Caregivers had significant improvement in IEQ sum scores from baseline to end-of-study (n=756; mean [SD] baseline score: 28.3 [15.34] points; mean [SD] improvement: 8.9 [14.73] points); most improvements seen in worrying (2.6 points) and urging (3.7 points) domains. There was significant relationship between improvement in IEQ sum scores and relapse status (p<0.001), and patient age (p<0.05); age of diagnosis, long-acting injectable (LAI) use at baseline, number and duration of prior psychiatric hospitalizations (<24 months) had no significant effect on improvement. Caregiver burden improvement was significant in patients on prior oral antipsychotics post switching to LAI with less leisure days being impacted and less hours spent in caregiving (p<0.001). Caregiver burden in family members of patients treated for schizophrenia is considerable. Switching from an oral antipsychotic to an LAI can provide a meaningful and significant improvement in caregiver burden.