Abstract
BackgroundTo evaluate the prevalence and impact of negative symptoms on healthcare resources utilization and costs in patients with schizophrenia.MethodsA retrospective study was conducted using electronic medical records from the health provider BSA (Badalona, Spain). All adult outpatients with a diagnosis of schizophrenia were followed for 12 months. Two study groups were defined by the presence or absence of negative symptoms based on the PANSS Negative Symptoms Factor (N1-N4, N6, G7 and G16). Healthcare (direct cost) and non-healthcare costs (work productivity losses) were described. An ANCOVA model was used for correction, p < 0.05.ResultsOne thousand one hundred and twenty patients were included in the study (mean age: 46.8 ± 13.8 years; male: 58.4%). One or more negative symptoms were present in 52.5% of patients (95% CI: 49.6-55.4%). The most frequent were passive/apathetic social withdrawal and emotional withdrawal (60.5% and 49.8%, respectively). Patients with negative symptoms showed a greater mean number of comorbid conditions and pharmacological treatments. The adjusted unit healthcare cost related to the presence/absence of negative symptoms was €2,190.80 and €1,787.60 and the healthcare cost was €2,085.00 and €1,659.10, respectively; (p < 0.001). Patients with negative symptoms used more healthcare resources, mainly derived from primary care. The presence of negative symptoms was associated with being male, dyslipidemia, obesity and arterial hypertension (OR = 1.7, 1.4, 1.4 and 1.2, respectively).ConclusionsNegative symptoms are highly prevalent in adult outpatients with schizophrenia with a relevant economic impact on the healthcare system.
Highlights
To evaluate the prevalence and impact of negative symptoms on healthcare resources utilization and costs in patients with schizophrenia
Using data from the CATIE trial of chronic schizophrenia, Rabinowitz et al found that baseline functioning and change in functioning were more strongly related to Positive and Negative Syndrome Scale (PANSS) negative symptom domains than any of the other symptoms [7]
Because of the proven impact that negative symptoms have on patient well-being, functioning, and health-related quality of life, it is crucial that clinicians can detect and address these symptoms early [8,9,10,11]
Summary
To evaluate the prevalence and impact of negative symptoms on healthcare resources utilization and costs in patients with schizophrenia. Schizophrenia is one of the leading causes of chronic incapacity and has a devastating impact on personal, social, and economic aspects of life [1,2]. Negative symptoms such as affective flattening, poverty of speech, general lack of motivation, asociality, and impaired attention are a critical unmet need for successful management of schizophrenia [3]. Because of the proven impact that negative symptoms have on patient well-being, functioning, and health-related quality of life, it is crucial that clinicians can detect and address these symptoms early [8,9,10,11]. Few studies suggested that there would be a positive association between direct medical costs and negative symptoms [16,17]
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