The Schizophrenia Outpatient Health Outcomes (SOHO) study: 3-year results of antipsychotic treatment discontinuation and related clinical factors in Spain.
BACKGROUND
This article presents the long-term results in terms of antipsychotic medication maintenance and factors influencing it in a representative sample of patients with schizophrenia recruited in the SOHO study within Spain.


METHODS
The SOHO was a prospective, 3-year observational study of the outcomes of schizophrenia treatment in outpatients who initiated therapy or changed to a new antipsychotic performed in 10 European countries with a focus on olanzapine. The Kaplan-Meier method was used to analyse the time to treatment discontinuation and the Cox proportional hazards model to investigate correlates of discontinuation.


CONCLUSIONS
In total, 1688 patients were included in the analyses. Medication maintenance at 3years varied with the antipsychotic prescribed, being highest with clozapine (57.6%, 95% CI 39.2-74.5), followed by olanzapine (48.3%, 95% CI 45.1-51.5); and lowest with quetiapine (19.0%, 95% CI 13.0-26.3). Treatment discontinuation was significantly less frequent with olanzapine than with risperidone (p=0.015), depot typical (p=0.001), oral typical antipsychotics (p<0.001) or quetiapine (p<0.001); but not than with clozapine (p=0.309). Longer maintenance was also associated with higher social abilities and better cognitive status at baseline; in contrast, a shorter time to discontinuation was associated with the need for mood stabilisers during follow-up. This study emphasises the different value of antipsychotics in day-to-day clinical practice, as some of them were associated with longer medication maintenance periods than others. This study has some limitations because of possible selection and information biases derived from the non-systematic, non-randomised allocation to treatments and the existence of unobserved covariates that may influence the outcome.
Ciudad
Antonio
A
Clinical Research, Department of Research and Development, Lilly, S.A. Avda. de la Industria, 30, 28108 Alcobendas, Madrid, Spain. ciudad_antonio@lilly.com
Haro
Josep María
JM
Alonso
Jordi
J
Bousoño
Manuel
M
Suárez
David
D
Novick
Diego
D
Gilaberte
Inmaculada
I
D000284:Administration, Oral; D000328:Adult; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D003024:Clozapine / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D000077152:Olanzapine; D017063:Outcome Assessment, Health Care; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011446:Prospective Studies; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D012565:Schizophrenic Psychology; D013030:Spain; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine