0:00:01hi my name is jennifer currently of a and i'm one of the co authors
0:00:05and a manuscript entitled management of in a psychotic treatment is continuation interruptions using model
0:00:13based simulations
0:00:15schizophrenia faxed slightly over one percent of the population over the age of eighteen
0:00:21with a estimates of fifty one million people suffering from schizophrenia worldwide
0:00:28ranks as one of the top ten causes a disability in developed countries worldwide
0:00:34fortunately schizophrenia is treatable with in a psychotic medications and psychosocial therapies
0:00:41unfortunately despite the availability of affective medications
0:00:46patients are often less than fully adhere it with their treatment
0:00:50is then estimated that the one here treatment interaction or complete this continuation rate but
0:00:57in a psychotic agents ranges between forty and seventy percent
0:01:01reasons for treatment interruption or just continuation vary widely and can range from a schizophrenia
0:01:08associated lack of insight into their condition and the importance of their medication
0:01:14to being forgot for wanting to avoid adverse advance
0:01:17or just making a conscious choice to start treatment
0:01:21for the patient the interruption or complete this continuation of in a psychotic there be
0:01:27is associated with a substantial increase in the risk for relapse or hospitalisation
0:01:33for the condition re initiating in a psychotic treatment in a patient who has interrupted
0:01:38or completely discontinue their treatment
0:01:41is based on several factors
0:01:44including the therapeutic agent
0:01:46whether it was orally administered or long acting intractable formulation
0:01:51and the duration of treatment interruption
0:01:53and this article my co investigators and i performed for marco kinetic model based simulations
0:02:00to analyze what would happen to the active more at plasma concentration profiles of the
0:02:07long acting intractable and oral formulation of how a pair down and we're stare down
0:02:12following one week upstream an interaction
0:02:15four weeks of treatment interruption or complete treatment this continuation
0:02:21polar bear don't inverse their down share a common form of code dynamic relationship
0:02:26in that how the pair down is the might have a late every spare
0:02:30with the both of these being active oily
0:02:34as illustrated in this simulation of treatment is continuation
0:02:38long acting intractable formulations of how the parrot on comedy
0:02:42and we're stare down provided longer durations of the active more at concentrations
0:02:48then their oral counterpart
0:02:50l appeared on comedy exhibited this lowest active oily concentration decline
0:02:56with respect to long acting injection being max
0:02:59and the oral agent having you rapid decline to near zero within a week
0:03:05for a variety of reasons
0:03:07patients often have interruptions and their medication treatment
0:03:12this next simulation depicts the active more at concentrations over time
0:03:17with a one week short-term interruption in treatment
0:03:22as in the previous simulation wrap it declines in acted more at concentrations
0:03:27occur with the oral agents
0:03:29and steady-state levels resume after a few days of treatment re initiation
0:03:35risk there are no longer acting injection has a unique release profile
0:03:40there is no substantial immediate release following its administration
0:03:45the main release of drought does not occur in so weak three following injection
0:03:50therefore
0:03:51this totally really used results in an
0:03:54to avoid to decline
0:03:56forty five weeks after a one week treatment interaction
0:04:01on the other hand we initiation of pell appeared on comedy
0:04:05produced in near immediate reading when a steady state active minute concentrations
0:04:11this next simulation depicts that active more at concentrations over time
0:04:16with a four week
0:04:17longer term interaction in treatment
0:04:20after four we treatment interaction
0:04:23nearly a week was required for re attainment a steady state active minute concentrations
0:04:29with world power pair down or were spared on
0:04:32the delayed release characteristic are first vary among acting injection
0:04:37requires three weeks of supplementation with or was there don't
0:04:41when intractable treatment is initiated for the first time
0:04:45or following a four week treatment interruption
0:04:48the use of oral we're stared on supplementation with three initiation of perspire down long
0:04:54acting injection
0:04:55results in erie establishment of steady-state active or at concentrations
0:05:00after a few cases
0:05:02however there was a short term decline between weeks seven and eight
0:05:08on the other hand
0:05:09we initiation the power paradigm comedy
0:05:12using soon doses administered one week apart
0:05:16with out any oral and a psychotic supplementation
0:05:19displayed in rapid we attainment of active more at concentrations
0:05:25in summary the release visual simulations
0:05:29we hope that you become better able to conceptualise the impact of non adherence
0:05:34and plasma concentrations
0:05:36and the impact of medications specific re initiation strategies after intermittent not adherence
0:05:44the findings of these model based simulations
0:05:47indicate that longer windows
0:05:49active more at concentrations
0:05:51occur
0:05:52for clinicians to intervene in the event of nine adherence
0:05:56to manage that only decreases in class a concentration
0:06:00with long acting intractable formulations of power pair don't and or stared on
0:06:05thank you for your interest
0:06:06and we hope that you find or analyses you scroll in the management i mean
0:06:11you work patients for receiving in a psychotic agents