Outcomes Study: Identifying Determinants of Medication Persistence in Rheumatoid Arthritis Using Machine Learning and Regression Analysis

Members of our team had the opportunity to present a new poster abstract at AAPP 2026, which was held from April 19-22, 2026. 

Authors

Anoop P. Kotian, PharmD; Taylor K. Haddock, PharmD, BCPP; Courtney A. Iuppa, PharmD, BCPP; Carrie R. Kris, MS; Dayton L. Antley, PharmD, BCPS, BCPP; Timothy Dellenbaigh, MD; Rhiannon Adams, PsyD

Background

• Competency to stand trial (CST) requires that defendants possess both a factual and rational understanding of legal proceedings, with the ability to assist counsel in their defense, as established in Duskey v. United States.^1,2

• Defendants found incompetent to stand trial (IST) are commonly admitted to forensic psychiatric hospitals for psychiatric treatment and competency-focused education aimed to restore competency within a realistic timeframe.^1,3

• Although about 80% of defendants admitted IST are restored to competency within 90 to 120 days, symptoms of severe psychosis or cognitive impairment may reduce or prolong the overall time to competency restoration.⁴

• Treatment-resistant schizophrenia (TRS), defined as nonresponse to at least two adequate trials of two different antipsychotics, further complicates management.⁵

• Limited data exists on the impact different antipsychotic treatment strategies have on time to competency restoration, particularly in TRS patients in forensic psychiatric settings.⁶

• Clozapine remains the only antispsychotic approved for TRS, however, 40% of patients who start clozapine fail therapy due to intolerance or non-response.⁷

• Alternative strategies, such as dual-antipsychotic therapy or clozapine augmentation, may be used in clozapine-resistant cases, though supporting evidence for these strategies is inconsistent.^8,9

Objectives

The purpose of this study was to evaluate the impact of antipsychotic treatment strategies on competency restoration in patients identified to have TRS.