Non-adherence to antipsychotic medication regimens: associations with resource use and costs.
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.
Knapp
Martin
M
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
King
Derek
D
Pugner
Klaus
K
Lapuerta
Pablo
P
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
D014150:Antipsychotic Agents