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Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia

BACKGROUND: Adherence to antipsychotics for schizophrenia is associated with favorable clinical outcomes. This study compared annual mental-health service utilization by recent medication adherence levels for patients treated for schizophrenia, and assessed whether adherence levels change from pre-...

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Autores principales: Ascher-Svanum, Haya, Zhu, Baojin, Faries, Douglas E, Furiak, Nicolas M, Montgomery, William
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628922/
https://www.ncbi.nlm.nih.gov/pubmed/19138402
http://dx.doi.org/10.1186/1756-0500-2-6
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author Ascher-Svanum, Haya
Zhu, Baojin
Faries, Douglas E
Furiak, Nicolas M
Montgomery, William
author_facet Ascher-Svanum, Haya
Zhu, Baojin
Faries, Douglas E
Furiak, Nicolas M
Montgomery, William
author_sort Ascher-Svanum, Haya
collection PubMed
description BACKGROUND: Adherence to antipsychotics for schizophrenia is associated with favorable clinical outcomes. This study compared annual mental-health service utilization by recent medication adherence levels for patients treated for schizophrenia, and assessed whether adherence levels change from pre- to post-psychiatric hospitalization. METHODS: We analyzed data from a large prospective, non-interventional study of patients treated for schizophrenia in the United States, conducted between 7/1997 and 9/2003. Detailed mental-health resource utilization was systematically abstracted from medical records and augmented with patients' self report. Medication possession ratio (MPR) with any antipsychotic in the 6 months prior to enrollment was used to categorize patients as: adherent (MPR ≥ 80%, N = 1758), partially adherent (MPR ≥ 60% < 80%, N = 36), or non-adherent (MPR < 60%, N = 216). Group comparisons employed propensity score-adjusted bootstrap re-sampling methods with 1000 iterations, adjusting for baseline patient demographic and clinical characteristics identified a priori. RESULTS: Adherent patients had a lower rate of psychiatric hospitalization compared with partially adherent and non-adherent patients (p < 0.001) and were more likely than non-adherent to engage in group therapy, individual therapy, and medication management. Most patients (92.0%) who were adherent in the 6 months prior to hospital admission continued to be adherent 6 months following hospitalization. However, 75.0% of previously partially adherent became adherent, and 38.7% of previously non-adherent became adherent following hospitalization. CONCLUSION: Adherence is associated with lower utilization of acute care services and greater engagement in outpatient mental-health treatment. Adherence is a potentially dynamic phenomenon, which may improve, at least temporarily, following patients' psychiatric hospitalizations.
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spelling pubmed-26289222009-01-21 Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia Ascher-Svanum, Haya Zhu, Baojin Faries, Douglas E Furiak, Nicolas M Montgomery, William BMC Res Notes Short Report BACKGROUND: Adherence to antipsychotics for schizophrenia is associated with favorable clinical outcomes. This study compared annual mental-health service utilization by recent medication adherence levels for patients treated for schizophrenia, and assessed whether adherence levels change from pre- to post-psychiatric hospitalization. METHODS: We analyzed data from a large prospective, non-interventional study of patients treated for schizophrenia in the United States, conducted between 7/1997 and 9/2003. Detailed mental-health resource utilization was systematically abstracted from medical records and augmented with patients' self report. Medication possession ratio (MPR) with any antipsychotic in the 6 months prior to enrollment was used to categorize patients as: adherent (MPR ≥ 80%, N = 1758), partially adherent (MPR ≥ 60% < 80%, N = 36), or non-adherent (MPR < 60%, N = 216). Group comparisons employed propensity score-adjusted bootstrap re-sampling methods with 1000 iterations, adjusting for baseline patient demographic and clinical characteristics identified a priori. RESULTS: Adherent patients had a lower rate of psychiatric hospitalization compared with partially adherent and non-adherent patients (p < 0.001) and were more likely than non-adherent to engage in group therapy, individual therapy, and medication management. Most patients (92.0%) who were adherent in the 6 months prior to hospital admission continued to be adherent 6 months following hospitalization. However, 75.0% of previously partially adherent became adherent, and 38.7% of previously non-adherent became adherent following hospitalization. CONCLUSION: Adherence is associated with lower utilization of acute care services and greater engagement in outpatient mental-health treatment. Adherence is a potentially dynamic phenomenon, which may improve, at least temporarily, following patients' psychiatric hospitalizations. BioMed Central 2009-01-12 /pmc/articles/PMC2628922/ /pubmed/19138402 http://dx.doi.org/10.1186/1756-0500-2-6 Text en Copyright © 2009 Ascher-Svanum et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Report
Ascher-Svanum, Haya
Zhu, Baojin
Faries, Douglas E
Furiak, Nicolas M
Montgomery, William
Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia
title Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia
title_full Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia
title_fullStr Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia
title_full_unstemmed Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia
title_short Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia
title_sort medication adherence levels and differential use of mental-health services in the treatment of schizophrenia
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628922/
https://www.ncbi.nlm.nih.gov/pubmed/19138402
http://dx.doi.org/10.1186/1756-0500-2-6
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