No abstract

The findings provide practical basis for designing interventions and programs aimed at compliance building in elderly populations having hypertension by incorporating the value and importance of patient perceptions of illness and medications in order to achieve desired patient outcomes.

BACKGROUND: Medication nonadherence to antipsychotic drugs, which is commonly seen in patients with schizophrenia who have comorbidities, not only affects the quality of life of individuals suffering from the condition, but can also lead to worsening of disease condition, adverse outcomes, excessive use of health care resources, and higher medical costs. OBJECTIVE: To determine the effect of nonadherence to antipsychotics and related disease comorbidities on medical care utilization with respect to inpatient hospital visits, outpatient visits, office visits, and emergency room (ER) visits.METHODS: Retrospective, cross-sectional research data was obtained from the Medical Expenditure Panel Surveys (MEPS) for the years 2010-2014. The proportion of days covered (PDC) adherence measure was used to identify and classify individuals as adherent (PDC ≥ 80%) or nonadherent (PDC < 80%). A logistic regression analysis was used to further examine the effect of key study variables and comorbidity on medication nonadherence in patients with schizophrenia. Using the Student's t-test, population characteristics were statistically compared between the adherent and nonadherent populations and between populations with comorbidities and without comorbidities with respect to inpatient, outpatient, office, and ER visits.RESULTS: Of 1.2 million people who reported having schizophrenia in MEPS from 2010 to 2014, as many as 71% were found to be nonadherent to antipsychotic medications (PDC < 80%). Results showed that women (OR = 3.594, 95% CI = 1.33-11.40, P = 0.030) and people with less than 15 years of education (OR = 20.85, 95% CI = 3.91-111.09, P = 0.0005) were more likely to be nonadherent to antipsychotic medications than all other demographics. Compared with the adherent schizophrenia population (n = 353,349), the nonadherent population (n = 868,737) had greater utilization of outpatient visits (0.68 vs. 1.92, P < 0.0001) and office visits (10.95 vs. 18.21, P < 0.0001) but had lower utilization of inpatient visits (0.82 vs. 0.45, P < 0.0001) and ER visits (1.03 vs. 0.79, P = 0.1036). Compared with the schizophrenia population without comorbidities, the population with comorbidities (a classification based on a Charlson Comorbidity Index score of ≥ 1) had greater utilization of inpatient (0.39 vs. 0.76, P < 0.0001); office (13.39 vs. 19.34, P < 0.0001); and ER visits (0.39 vs. 1.41, P < 0.0001) but had lower utilization of outpatient visits (1.86 vs. 1.21, P < 0.0001).CONCLUSIONS: Greater medical care resources are used by nonadherent populations with schizophrenia and comorbidities than those without comorbidities. Together, nonadherence and comorbidities pose significant risks to patients with schizophrenia, in clinical and financial terms, and addressing problems stemming from such risks should be an area of priority in schizophrenia management.

The regulatory warnings and labeling changes regarding off-label use of AAPs in dementia treatment showed minimal impact on their actual use in noninstitutionalized populations. A corresponding increase in the use of nonantipsychotic psychotropics explains that BBW might have resulted in a compensatory shift in favor of benzodiazepines and antidementia medications. Additional research should be conducted to examine the long-term impact of BBW on antipsychotic prescribing changes.

Background:Sexual dysfunction (SD) is a known adverse effect of psychotropic medications. Even though sexual difficulties are common among women; very few studies have been carried out in India.Objective:To study the prevalence and nature of SD among females receiving psychotropic medications and to compare the SD among female patients receiving antipsychotics and antidepressants.Materials and Methods:Female investigator conducted a hospital-based cross-sectional study on female patients visiting the psychiatry outpatient department. Patients meeting inclusion criteria were assessed for SD disorder as per Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision. SD severity was measured using Female Sexual Function Index (FSFI) scale.Results:The prevalence of SD in this study was 68.32%. There was more than one SD in 48 (47.52%). FSFI score was significantly low in patients with SD as compared to patients not having SD (P = 0.001). SD was more common in patients who were on combination of antidepressants and benzodiazepines than antidepressant alone or antipsychotic alone.Conclusion:SD was prevalent in more than 50% of female patients on psychotropic drugs. Number of patients on individual psychotropic drugs was so small that a definite conclusion could not be drawn. Study emphasizes the need to carry out similar study on larger number of patients to get better insight into this problem.