Healthcare resource utilization, adherence and persistence with antipsychotic therapy among schizophrenia patients with vs. without pre-existing metabolic syndrome.
OBJECTIVE
To assess the association between pre-existing metabolic syndrome and health outcomes among veterans with schizophrenia.


METHODS
The Veterans Integrated Service Network 16 data (VISN16) for 10/2002 - 08/2005 were used to identify patients (n = 593) with schizophrenia (ICD-9 codes: 250.xx) who were switched to a new antipsychotic agent in response to metabolic monitoring as part of a VISN 16 metabolic monitoring program. Two groups (patients with pre-existing metabolic syndrome [MetSyn+] and without [MetSyn-]) were compared on resource utilization, antipsychotic adherence (medication possession ratio: MPR) and persistence (time to all-cause discontinuation of the switched antipsychotic) over 1 year.


RESULTS
About one-third of the patients who have undergone metabolic monitoring before the medication switch (35.2%) had metabolic syndrome. The two groups did not significantly differ on healthcare resource utilization, MPR, or time to all-cause medication discontinuation. Adherence and persistence levels were relatively poor for both groups (mean MPR = 0.33 for MetSyn+; MPR = 0.38 for MetSyn-). The median time to all-cause medication discontinuation was 50 days for both groups.


CONCLUSIONS
In this retrospective study of patients with schizophrenia, the presence of pre-existing metabolic syndrome did not appear to impact patients' healthcare resource utilization or their adherence and persistence with antipsychotic medication.
Shi
Lizheng
L
Tulane University and Southeast Louisiana Veterans Health Care System, New Orleans, LA 70112, USA. lshi1@tulane.edu
Zhao
Yingnan
Y
Fonseca
Vivian
V
Ascher-Svanum
Haya
H
Chiang
Yi-Ju
YJ
Winstead
Daniel
D
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D057915:Drug Substitution / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data; D016903:Drug Monitoring
D014150:Antipsychotic Agents