Abstract
Aims and methodRelapse in schizophrenia carries a heavy burden. This study aimed to describe the characteristics of patients admitted to hospital for relapse and to explore the treatment, length of stay and associated in-patient costs. The sample comprised individuals discharged from a London National Health Service trust following a relapse of schizophrenia. The costs of hospital treatment were obtained by applying referenced unit costs.ResultsThe cohort comprised 71 patients. Treatment non-adherence was implicated in 76% of relapses. Mean length of hospital stay was 138.9 days (range 1 week-1.8 years). Mean admission cost was £25 852 (range £1270-120 000). Over 97% of costs were hospital costs and less than 3% drug costs.Clinical implicationsHospital treatment for relapse of schizophrenia carries a considerable economic burden, as shown in this study. Treatment non-adherence is a significant factor contributing to relapse.
Highlights
The risk of relapse for a person with schizophrenia has been estimated at 3.5% per month[6] and approximately 40% experience a relapse within the year following hospital admission.[7]
The circumstances precipitating hospital admission assessed in the study were reviewed and individuals admitted for reasons other than a schizophrenia relapse were excluded
This study demonstrates the considerable economic costs of hospital admissions precipitated by a relapse in individuals with schizophrenia
Summary
A total of 112 in-patients met the eligibility criteria, of whom 71 consented to participate. Olanzapine was prescribed most frequently (10%; n = 7) and sodium valproate, clozapine, quetiapine, oral risperidone and risperidone depot injection were each used in 4% (n = 3) of individuals on admission. History of clozapine, ethnicity, gender, age at diagnosis, and 5-year history of admission and drug misuse were not significantly correlated with the cost of relapse in this cohort. Among the 12 individuals who were prescribed atypical oral antipsychotics on admission, 6 were discharged on the same treatment they were admitted on (50%), 4 switched to or added depot medication (33%) and 2 stopped antipsychotic treatment (17%). The two individuals on a single depot antipsychotic remained on the same treatment and the two receiving clozapine on admission were added an
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