Patient satisfaction with psychotropic drugs: sensitivity to change and relationship to clinical status, quality-of-life, compliance and effectiveness of treatment. Results from a nation-wide 6-month prospective study.
OBJECTIVE
To see if patient satisfaction with psychotropics (PSP) could be used as a patient-oriented outcome variable in the evaluation of PSP drugs in clinical epidemiological studies, relationships between PSP, clinical status, QoL, compliance and the type of antipsychotic were analyzed. Elements of validation of PSP were also assessed.


METHODS
In a 6-month prospective study, 933 schizophrenic outpatients with initiation or change to their antipsychotic treatment were enrolled. Psychiatrists completed five CGI-SCH scales (positive, negative, cognitive, depressive and global), hospitalization, compliance, and prescription variables. Patients completed PSP, EuroQoL scales, sexual function and compliance variables.


RESULTS
A satisfactory structural equation model was obtained showing significant relationships PSP/compliance (coef.=0.16), QoL/PSP (coef.=0.37), clinical status/QoL (coef.=0.61), clinical status/compliance (coef.=0.09). Patients receiving olanzapine were more satisfied than patients receiving other atypicals (coef.=012) and had better clinical status than patients treated with typicals (coef.=0.08). Evolution of PSP was related to clinical status, QoL, and continuation of treatment (all P<001). Sensitivity to change of PSP was moderate (effect size=0.2).


CONCLUSIONS
PSP produced consistent results in relation to validated outcome variables. However, a single-item measure was not sufficiently sensitive to change. Multi-item questionnaires evaluating different dimensions are needed.
Gasquet
Isabelle
I
National Institute of Health and Medical Research-U669 (Paris-Sud Innovation Group in Adolescent Mental Health Methodology), Maison des Adolescents, Cochin Hospital, Paris, France. isabelle.gasquet@sap.aphp.fr
Tcherny-Lessenot
Stéphanie
S
Lépine
Jean-Pierre
JP
Falissard
Bruno
B
D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011788:Quality of Life; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D011619:Psychotropic Drugs