Abstract
Objective To describe and compare demographics, outcomes and comorbidities in schizophrenia patients by treatment compliance. Methods This was a cross-sectional survey of hospital- or office-based psychiatrists who saw ≥6 schizophrenia patients per week and were responsible for treatment decisions. Recruited physicians completed a patient record form (PRF) for their first 10 consulted schizophrenia patients aged ≥18. These patients voluntarily completed a patient self-completion form (PSC). Compliance was measured by subjective physician assessment. Drivers of and outcomes associated with compliance were identified by regression analyses. Results A total of 150 physicians completed PRFs for 1489 patients (706 sometimes compliant (SC), 636 always compliant (AC)). A total of 680 patients completed a PSC (327 SC, 295 AC). AC patients were less likely to be male (52.2% vs. 58.6%; P = 0.021) and unemployed (odds ratio (OR) 0.91, 95% confidence interval (CI) 0.82–1.00; P < 0.001) or to have had a treatment regimen change (OR 0.56, 95% CI 0.40–0.80; P = 0.001) than SC patients. AC patients were less likely to have had more comorbidities (OR 0.91, 95% CI 0.82–1.00; P = 0.045) and hospitalizations in the past 12 months (OR 0.59, 95% CI 0.43–0.80; P = 0.001) than SC patients. Overall, AC patients had better clinical and humanistic outcomes. Weight gain was a common side effect for all patients; SC patients with weight gain had poorer outcomes than those without weight gain. Conclusion Schizophrenia patients that were SC experienced poorer clinical outcomes and quality of life. Weight gain may exacerbate these poorer outcomes.
Highlights
Schizophrenia is the most common psychotic disorder [1], with approximately 7 in 1000 patients developing the disease in their lifetime [2]
Absolute prevalence is low, the disease is accompanied by substantial health, social and economic burdens [5] and people with schizophrenia are two to three times more likely to die early than the general population [3]
A systematic review revealed that the total costs of schizophrenia across various countries ranged from US $94 million (Puerto Rico) to US $102 billion (US) [5]
Summary
Schizophrenia is the most common psychotic disorder [1], with approximately 7 in 1000 patients developing the disease in their lifetime [2]. Schizophrenia affects more than 23 million people worldwide [3]; approximately 2.6 million adults in the US have the disease [4]. Absolute prevalence is low, the disease is accompanied by substantial health, social and economic burdens [5] and people with schizophrenia are two to three times more likely to die early than the general population [3]. The first-line pharmacotherapies for schizophrenia are antipsychotic agents, including firstgeneration (typical) and second-generation (atypical) agents. While first- and second-generation antipsychotics demonstrate equivalent effectiveness [9, 10], second-generation
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