Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR)

Eur Psychiatry. 2009 Jun;24(5):287-96. doi: 10.1016/j.eurpsy.2008.12.002. Epub 2009 Feb 4.


Background: The electronic Schizophrenia Treatment Adherence Registry (e-STAR) is a prospective, observational study of patients with schizophrenia designed to evaluate long-term treatment outcomes in routine clinical practice.

Methods: Parameters were assessed at baseline and at 3 month intervals for 2 years in patients initiated on risperidone long-acting injection (RLAI) (n=1345) or a new oral antipsychotic (AP) (n=277; 35.7% and 36.5% on risperidone and olanzapine, respectively) in Spain. Hospitalization prior to therapy was assessed by a retrospective chart review.

Results: At 24 months, treatment retention (81.8% for RLAI versus 63.4% for oral APs, p<0.0001) and reduction in Clinical Global Impression Severity scores (-1.14 for RLAI versus -0.94 for APs, p=0.0165) were significantly higher with RLAI. Compared to the pre-switch period, RLAI patients had greater reductions in the number (reduction of 0.37 stays per patient versus 0.2, p<0.05) and days (18.74 versus 13.02, p<0.01) of hospitalizations at 24 months than oral AP patients.

Conclusions: This 2 year, prospective, observational study showed that, compared to oral antipsychotics, RLAI was associated with better treatment retention, greater improvement in clinical symptoms and functioning, and greater reduction in hospital stays and days in hospital in patients with schizophrenia. Improved treatment adherence, increased efficacy and reduced hospitalization with RLAI offer the opportunity of substantial therapeutic improvement in schizophrenia.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Benzodiazepines / administration & dosage
  • Benzodiazepines / adverse effects
  • Delayed-Action Preparations
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intramuscular
  • Long-Term Care
  • Male
  • Medication Adherence*
  • Middle Aged
  • Olanzapine
  • Patient Readmission / statistics & numerical data
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Registries
  • Risperidone / administration & dosage*
  • Risperidone / adverse effects
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology*


  • Antipsychotic Agents
  • Delayed-Action Preparations
  • Benzodiazepines
  • Risperidone
  • Olanzapine