OBJECTIVE To determine if a single baseline adherence assessment (Brief Adherence Rating Scale [BARS]) could identify patients who are likely to respond to long-acting injectable (LAI) antipsychotic treatment. METHOD The current secondary analysis included a sub-sample of adult outpatients (N = 176) with schizophrenia or schizoaffective disorder who participated in the "A Comparison of Long-Acting Injectable Medications for Schizophrenia (ACLAIMS)" trial and had a baseline BARS assessment and a baseline and month 3 Positive and Negative Syndrome Scale (PANSS) rating. The main outcome was LAI treatment response, defined as a ≥ 20% decrease (baseline to month 3) on the PANSS total score. Receiver Operating Characteristic (ROC) and Area Under the Curve (AUC) analysis was conducted to determine the optimal cutpoint of baseline BARS adherence in discriminating LAI treatment response at month 3. A logistic mixed model estimated the odds of response to LAI treatment at month 3 from the optimal baseline BARS cutpoint. RESULTS The ROC analysis determined that the single baseline BARS rating (cutoff ≤66%), indicating low adherence, best discriminated patients likely to respond to LAI treatment (AUC = 0.603, SE = 0.046, 95% binomial exact CI = 0.527 to 0.676, p = 0.025), with 38% sensitivity and 85% specificity. The logistic mixed model analysis revealed that patients with ≤66% BARS adherence had 3.464 times the predicted odds (95% CI = 1.604 to 7.480, p = 0.001) of responding to LAI treatment than those who were >66% BARS adherent. CONCLUSION A single baseline BARS assessment discriminated response to LAI treatment suggesting it is a reasonable tool to identify candidates for LAI antipsychotic treatment.

中文翻译：

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使用简短依从性评定量表 (BARS) 进行的单一评估可区分精神分裂症患者对长效注射抗精神病药物治疗的反应者

目的 确定单一基线依从性评估（简要依从性评定量表 [BARS]）是否可以识别可能对长效注射剂 (LAI) 抗精神病药治疗有反应的患者。方法 当前的二级分析包括参与“精神分裂症长效注射药物比较 (ACLAIMS)”试验并进行基线 BARS 评估和基线和第 3 个月阳性和阴性综合征量表 (PANSS) 评级。主要结果是 LAI 治疗反应，定义为 PANSS 总分下降 ≥ 20%（基线至第 3 个月）。进行接受者操作特征 (ROC) 和曲线下面积 (AUC) 分析以确定基线 BARS 依从性在第 3 个月区分 LAI 治疗反应的最佳临界点。逻辑混合模型估计第 3 个月对 LAI 治疗反应的几率从最佳基线 BARS 切点。结果 ROC 分析确定单一基线 BARS 评分（截止值≤66%），表明依从性低，最容易区分患者可能对 LAI 治疗有反应（AUC = 0.603，SE = 0.046，95% 二项式精确 CI = 0.527 至 0.676， p = 0.025)，灵敏度为 38%，特异性为 85%。Logistic 混合模型分析显示，BARS 依从性≤66% 的患者对 LAI 治疗有反应的预测比值（95% CI = 1.604 至 7.480，p = 0.001）是 BARS 依从性 >66% 的患者的 3.464 倍。