title: Non-adherence to antipsychotic medication regimens: associations with resource use and costs.
abstract: BACKGROUND
  Several factors are thought to influence resource use and costs in treating schizophrenia.
  
  
  OBJECTIVE
  To assess the relative impact of non-adherence and other factors associated with resource use and costs incurred by people with schizophrenia.
  
  
  METHODS
  Secondary analyses were made of data from a 1994 national survey of psychiatric morbidity among adults living in institutions in the UK. Factors potentially relating to resource use and costs were examined using two-part models.
  
  
  RESULTS
  Patients who failed to adhere to their medication regimen were over one-and-a-half times as likely as patients who did adhere to it to report use of in-patient services. Non-adherence is one of the most significant factors in increasing external service costs, by a factor of almost 3. Non-adherence predicted an excess annual cost per patient of approximately 2500 British pounds for in-patient services and over 5000 British pounds for total service use.
  
  
  CONCLUSIONS
  Resource use and costs are influenced by various factors. Medication non-adherence consistently exhibits an association with higher costs. Further important factors are patient needs and the ability of the system to address them.
authors.affiliation: LSE Health and Social Care, London School of Economics and Political Science, and Centre for the Economics of Mental Health, Institute of Psychiatry, London, UK. M.Knapp@ise.ac.uk
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.forename: Derek
authors.initials: D
authors.lastname: King
authors.forename: Klaus
authors.initials: K
authors.lastname: Pugner
authors.forename: Pablo
authors.initials: P
authors.lastname: Lapuerta
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000191:economics / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics; D012112:Residential Facilities; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics / Q000208:ethnology; D013997:Time Factors; D016312:Treatment Refusal
chemical_list: D014150:Antipsychotic Agents