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Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness

OBJECTIVE: To evaluate differences in patient characteristics and real-world outcomes in two distinct high-risk cohorts of patients with serious mental illness (SMI). METHODS: Retrospective cross-sectional analysis using a national multi-payer claims database. Two SMI cohorts identified by a technic...

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Autores principales: Forma, Felicia, Green, Teresa, Kim, Seung, Teigland, Christie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027903/
https://www.ncbi.nlm.nih.gov/pubmed/32104024
http://dx.doi.org/10.2147/CEOR.S231000
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author Forma, Felicia
Green, Teresa
Kim, Seung
Teigland, Christie
author_facet Forma, Felicia
Green, Teresa
Kim, Seung
Teigland, Christie
author_sort Forma, Felicia
collection PubMed
description OBJECTIVE: To evaluate differences in patient characteristics and real-world outcomes in two distinct high-risk cohorts of patients with serious mental illness (SMI). METHODS: Retrospective cross-sectional analysis using a national multi-payer claims database. Two SMI cohorts identified by a technical expert panel—patients recently discharged (RD) from an SMI-related hospitalization and early episode (EE) patients—were evaluated for antipsychotic medication adherence, healthcare utilization, and spending patterns. RESULTS: The analysis included 51,705 patients with bipolar disorder, major depressive disorder, and schizophrenia. More than half were over age 46 and >60% were female. Adherence to psychiatric medications was low (52.5% RD and 16.1% EE). More than half of RD and 100% of EE patients switched medications at least once annually, but 19% of RD patients switched ≥2 times compared to 14% of EE. The RD cohort (generally older and sicker) had higher psychiatric related utilization and higher annual costs (US$21,171 versus US$15,398). In both cohorts, women were more likely to have an emergency department (ED) and primary care provider (PCP) visit, but less likely to be hospitalized. Patients age <46 were less likely to have a PCP visit and more likely to have an ED visit, but younger patients age 18–24 were less likely to be hospitalized. CONCLUSION: Efforts to manage SMI are confounded by heterogeneity and low adherence to treatment. By better understanding which patients are at higher risk for specific adverse outcomes, clinicians can target interventions more appropriately to reduce the significant burden of SMI.
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spelling pubmed-70279032020-02-26 Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness Forma, Felicia Green, Teresa Kim, Seung Teigland, Christie Clinicoecon Outcomes Res Original Research OBJECTIVE: To evaluate differences in patient characteristics and real-world outcomes in two distinct high-risk cohorts of patients with serious mental illness (SMI). METHODS: Retrospective cross-sectional analysis using a national multi-payer claims database. Two SMI cohorts identified by a technical expert panel—patients recently discharged (RD) from an SMI-related hospitalization and early episode (EE) patients—were evaluated for antipsychotic medication adherence, healthcare utilization, and spending patterns. RESULTS: The analysis included 51,705 patients with bipolar disorder, major depressive disorder, and schizophrenia. More than half were over age 46 and >60% were female. Adherence to psychiatric medications was low (52.5% RD and 16.1% EE). More than half of RD and 100% of EE patients switched medications at least once annually, but 19% of RD patients switched ≥2 times compared to 14% of EE. The RD cohort (generally older and sicker) had higher psychiatric related utilization and higher annual costs (US$21,171 versus US$15,398). In both cohorts, women were more likely to have an emergency department (ED) and primary care provider (PCP) visit, but less likely to be hospitalized. Patients age <46 were less likely to have a PCP visit and more likely to have an ED visit, but younger patients age 18–24 were less likely to be hospitalized. CONCLUSION: Efforts to manage SMI are confounded by heterogeneity and low adherence to treatment. By better understanding which patients are at higher risk for specific adverse outcomes, clinicians can target interventions more appropriately to reduce the significant burden of SMI. Dove 2020-02-14 /pmc/articles/PMC7027903/ /pubmed/32104024 http://dx.doi.org/10.2147/CEOR.S231000 Text en © 2020 Forma et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Forma, Felicia
Green, Teresa
Kim, Seung
Teigland, Christie
Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness
title Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness
title_full Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness
title_fullStr Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness
title_full_unstemmed Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness
title_short Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness
title_sort antipsychotic medication adherence and healthcare services utilization in two cohorts of patients with serious mental illness
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027903/
https://www.ncbi.nlm.nih.gov/pubmed/32104024
http://dx.doi.org/10.2147/CEOR.S231000
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