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Treatment discontinuation and clinical outcomes in the 1-year naturalistic treatment of patients with schizophrenia at risk of treatment nonadherence.

Kelin K, Lambert T, Brnabic AJ, Newton R, Ye W, Escamilla RI, Chen KP, Don L, Montgomery W, Karagianis J, Ascher-Svanum H - Patient Prefer Adherence (2011)

Bottom Line: During the study, patients' clinical and functional status improved significantly and service use was low.Although identified as at risk of nonadherence, few patients in this naturalistic study discontinued their prescribed antipsychotic medication during the study.The discrepancy between the physicians' perception of their patient's medication adherence and the patients' self-perceived adherence highlights the need to better understand the underlying reasons for this phenomenon.

View Article: PubMed Central - PubMed

Affiliation: Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia;

ABSTRACT

Background: This study aimed to improve physicians' understanding of the treatment circumstances and needs of outpatients with schizophrenia at risk of nonadherence, by naturalistically assessing antipsychotic treatment patterns, clinical outcomes, and health care service use in this little-studied patient population.

Methods: In this one-year, prospective, multicenter, noninterventional, observational study, patients considered at risk of nonadherence by their physicians were switched from their primary oral antipsychotic to another oral or a depot antipsychotic at study entry. All cause treatment discontinuation (antipsychotic switch, augmentation, or discontinuation) during the study was assessed using Kaplan-Meier survival analyses and descriptive statistics. Patients' illness severity, quality of life, attitude towards medication, patient-reported adherence, and health care resource utilization were assessed during the study.

Results: Of the 406 enrolled patients, 43 (10.6%) were switched to depot and 363 (89.4%) were switched to oral antipsychotics at study entry. During the study, 99 (24.4%) patients switched, augmented, or discontinued their antipsychotic (all cause treatment discontinuation). Of the 99 patients who switched, augmented, or discontinued their antipsychotic, 8 (18.6%) were taking depot and 91 (25.0%) were taking oral antipsychotics. These patients were switched to either depot (n = 15) or oral (n = 78) antipsychotics, or discontinued their antipsychotic medication (n = 6). Inadequate response was the most frequently reported reason for medication discontinuation. During the study, patients' clinical and functional status improved significantly and service use was low. Most patients considered themselves to be adherent at study entry, and this favorable self-perception increased during the study (from 68.5% to 88.1%).

Conclusion: Although identified as at risk of nonadherence, few patients in this naturalistic study discontinued their prescribed antipsychotic medication during the study. The discrepancy between the physicians' perception of their patient's medication adherence and the patients' self-perceived adherence highlights the need to better understand the underlying reasons for this phenomenon.

No MeSH data available.


Related in: MedlinePlus

Patient disposition.
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getmorefigures.php?uid=PMC3105874&req=5

f1-ppa-5-213: Patient disposition.

Mentions: Figure 1 provides an overview of patient disposition at study entry, which has previously been reported in detail.21 Of the 440 patients considered to be at risk of nonadherence and who entered the study, 406 patients were enrolled (Australia, n = 64; Mexico, n = 40; Romania, n = 156; Taiwan, n = 146). The remaining 34 patients were excluded because of no data entry (n = 4), no antipsychotic change (n = 22), or an antipsychotic switch more than 90 days before study entry (n = 8).


Treatment discontinuation and clinical outcomes in the 1-year naturalistic treatment of patients with schizophrenia at risk of treatment nonadherence.

Kelin K, Lambert T, Brnabic AJ, Newton R, Ye W, Escamilla RI, Chen KP, Don L, Montgomery W, Karagianis J, Ascher-Svanum H - Patient Prefer Adherence (2011)

Patient disposition.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3105874&req=5

f1-ppa-5-213: Patient disposition.
Mentions: Figure 1 provides an overview of patient disposition at study entry, which has previously been reported in detail.21 Of the 440 patients considered to be at risk of nonadherence and who entered the study, 406 patients were enrolled (Australia, n = 64; Mexico, n = 40; Romania, n = 156; Taiwan, n = 146). The remaining 34 patients were excluded because of no data entry (n = 4), no antipsychotic change (n = 22), or an antipsychotic switch more than 90 days before study entry (n = 8).

Bottom Line: During the study, patients' clinical and functional status improved significantly and service use was low.Although identified as at risk of nonadherence, few patients in this naturalistic study discontinued their prescribed antipsychotic medication during the study.The discrepancy between the physicians' perception of their patient's medication adherence and the patients' self-perceived adherence highlights the need to better understand the underlying reasons for this phenomenon.

View Article: PubMed Central - PubMed

Affiliation: Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia;

ABSTRACT

Background: This study aimed to improve physicians' understanding of the treatment circumstances and needs of outpatients with schizophrenia at risk of nonadherence, by naturalistically assessing antipsychotic treatment patterns, clinical outcomes, and health care service use in this little-studied patient population.

Methods: In this one-year, prospective, multicenter, noninterventional, observational study, patients considered at risk of nonadherence by their physicians were switched from their primary oral antipsychotic to another oral or a depot antipsychotic at study entry. All cause treatment discontinuation (antipsychotic switch, augmentation, or discontinuation) during the study was assessed using Kaplan-Meier survival analyses and descriptive statistics. Patients' illness severity, quality of life, attitude towards medication, patient-reported adherence, and health care resource utilization were assessed during the study.

Results: Of the 406 enrolled patients, 43 (10.6%) were switched to depot and 363 (89.4%) were switched to oral antipsychotics at study entry. During the study, 99 (24.4%) patients switched, augmented, or discontinued their antipsychotic (all cause treatment discontinuation). Of the 99 patients who switched, augmented, or discontinued their antipsychotic, 8 (18.6%) were taking depot and 91 (25.0%) were taking oral antipsychotics. These patients were switched to either depot (n = 15) or oral (n = 78) antipsychotics, or discontinued their antipsychotic medication (n = 6). Inadequate response was the most frequently reported reason for medication discontinuation. During the study, patients' clinical and functional status improved significantly and service use was low. Most patients considered themselves to be adherent at study entry, and this favorable self-perception increased during the study (from 68.5% to 88.1%).

Conclusion: Although identified as at risk of nonadherence, few patients in this naturalistic study discontinued their prescribed antipsychotic medication during the study. The discrepancy between the physicians' perception of their patient's medication adherence and the patients' self-perceived adherence highlights the need to better understand the underlying reasons for this phenomenon.

No MeSH data available.


Related in: MedlinePlus