Preferences for schizophrenia treatment outcomes among public policy makers, consumers, families, and providers.

Abstract

This study measured state public policy makers' ratings of the importance of several key schizophrenia treatment outcomes and compared them with the ratings of primary stakeholders in schizophrenia treatment. Three groups of policy makers (40 administrative decision makers, 40 state legislators, and 20 legislative aides) and three groups of core stakeholders (20 persons with schizophrenia, 13 of their family members, and 20 of their mental health care providers) were recruited in Florida. Participants rated 12 descriptions of schizophrenia-related health states that reflected better and worse outcomes in six domains: psychotic symptoms, deficit symptoms, medication side effects, productive activity, daily activity, and social activity. All participants valued functional outcomes, such as improved productive and social activity, more than they valued improvements in symptoms. Public policy makers and primary stakeholders differed in the value they placed on two of the six outcomes. Compared with primary stakeholders, policy makers valued improvements in social functioning significantly more and improvements in medication side effects significantly less. Policy makers and primary stakeholders place similar value on some of the major goals of schizophrenia treatment, with both groups valuing functional outcomes most highly. However, the difference between groups in the importance placed on medication side effects may lead to conflicts in the allocation of resources to the provision of newer and more expensive medications, which are associated with fewer side effects. This initial examination of policy makers' views provides a starting point for developing consensus about schizophrenia treatment policies.