title: Healthcare resource utilization, adherence and persistence with antipsychotic therapy among schizophrenia patients with vs. without pre-existing metabolic syndrome.
abstract: 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.
authors.affiliation: Tulane University and Southeast Louisiana Veterans Health Care System, New Orleans, LA 70112, USA. lshi1@tulane.edu
authors.forename: Lizheng
authors.initials: L
authors.lastname: Shi
authors.forename: Yingnan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Vivian
authors.initials: V
authors.lastname: Fonseca
authors.forename: Haya
authors.initials: H
authors.lastname: Ascher-Svanum
authors.forename: Yi-Ju
authors.initials: YJ
authors.lastname: Chiang
authors.forename: Daniel
authors.initials: D
authors.lastname: Winstead
mesh_terms: 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
chemical_list: D014150:Antipsychotic Agents