Burden of schizophrenia in recently diagnosed patients: healthcare utilisation and cost perspective

Nicholl, Deborah; Akhras, Kasem; Diels, Joris; Schadrack, Jan

doi:10.1185/03007991003658956

Cited by 80 publications

(62 citation statements)

References 42 publications

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“…Inpatient care represents the primary driver of costs associated with schizophrenia, accounting for between one-third and two-thirds of the total direct health care costs of patients with schizophrenia [3-6]. Indeed, most of these patients will experience a chronic course with many relapses, characterized by an exacerbation of psychosis, emergency room (ER) visits, and rehospitalizations [7-9].…”

Section: Introductionmentioning

confidence: 99%

Impact of atypical long-acting injectable versus oral antipsychotics on rehospitalization rates and emergency room visits among relapsed schizophrenia patients: a retrospective database analysis

et al. 2013

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BackgroundAmong schizophrenia patients relapsed on an oral antipsychotic (AP), this study compared the impact of switching to atypical AP long-acting injectable therapy (LAT) versus continuing oral APs on hospitalization and emergency room (ER) visit recurrence.MethodsElectronic records from the Premier Hospital Database (2006-2010) were analyzed. Adult patients receiving oral APs during a schizophrenia-related hospitalization were identified and, upon relapse (i.e., rehospitalization for schizophrenia), were stratified into (a) patients switching to atypical LAT and (b) patients continuing with oral APs. Atypical LAT relapse patients were matched 1:3 with oral AP relapse patients, using a propensity score model. Andersen-Gill Cox proportional hazards models assessed the impact of atypical LAT versus oral AP on time to multiple recurrences of all-cause hospitalizations and ER visits. No adjustment was made for multiplicity.ResultsAtypical LAT (N = 1032) and oral AP (N = 2796) patients were matched and well-balanced with respect to demographic (mean age: 42.1 vs 42.4 years, p = .5622; gender: 43.6% vs 44.6% female, p = .5345), clinical, and hospital characteristics. Over a mean 30-month follow-up period, atypical LATs were associated with significantly lower mean number of rehospitalizations (1.25 vs 1.61, p < .0001) and ER visits (2.33 vs 2.67, p = .0158) compared with oral APs, as well as fewer days in hospital (mean days: 13.46 vs. 15.69, p = .0081). Rehospitalization (HR 0.81, 95% CI 0.76–0.87, p < .0001) and ER visit (HR 0.88, 95% CI 0.87–0.93, p < .0001) rates were significantly lower for patients receiving atypical LAT versus oral APs.ConclusionsThis hospital database analysis found that in relapsed schizophrenia patients, atypical LATs were associated with lower rehospitalization and ER visit rates than oral APs.

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Section: Introductionmentioning

confidence: 99%

Impact of atypical long-acting injectable versus oral antipsychotics on rehospitalization rates and emergency room visits among relapsed schizophrenia patients: a retrospective database analysis

et al. 2013

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“…The annual frequencies of relapses requiring hospitalization and relapses not requiring hospitalization were obtained from a 2010 US burden of illness article by Nicholl et al 35 , which reported the mean number of psychiatric hospitalizations and ER visits per patient with schizophrenia per year (Table 1). …”

Section: Relapse Frequency and Durationmentioning

confidence: 99%

The threshold rate of oral atypical anti-psychotic adherence at which paliperidone palmitate is cost saving

Edwards¹,

Muser

Doshi

et al. 2012

Journal of Medical Economics

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“…Enhancing patients’ cognition will not only improve their quality of life, but will also enable them to access jobs and integrate with society. In consequence, governments are relieved from the cost burden of ongoing care for these patients (Nicholl et al 2010). In keeping with this, we have shown that PCE drugs improve cognitive performance in patients with schizophrenia (Barnett et al 2010), and that modafinil (Provigil®), a wake-promoting drug licensed for narcolepsy, can improve cognitive flexibility as measured by extra-dimensional attentional set-shifting in patients with chronic schizophrenia (Turner et al 2004 a ).…”

Section: Pharmacological Cognitive Enhancers (Pces)mentioning

confidence: 99%

The ethics of elective psychopharmacology

Mohamed

Sahakian

2011

Int. J. Neuropsychopharm.

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Pharmacological cognitive enhancers (PCEs) are used to improve cognitive functions, such as attention, learning, memory and planning in patients with impairments in cognition resulting from traumatic brain injury (TBI) or from neuropsychiatric disorders such as Alzheimer's disease (AD), mild cognitive impairment, schizophrenia, and attention deficit hyperactivity disorder (ADHD). Moreover, PCEs have been shown to improve cognition in healthy volunteers with no psychiatric disorders. This article describes the rationale behind the need for their use in neuropsychiatric patients and illustrates how PCEs can ameliorate cognitive impairments, improve quality of life and wellbeing, and therefore reduce the economic burden associated with these disorders. We also describe evidence that PCEs are being used as cognitive enhancers by healthy people. Crucially, as the lifestyle use of these drugs becomes very popular in the healthy population, a final aim is to present an overview of the current and future neuroethical considerations of enhancing the healthy brain. As information regarding their actual use, benefits and harms in various healthy populations is currently lacking, we propose research that aims to obtain relevant empirical data, monitor the short- and long-term effectiveness and side-effects, and initiate accurate surveys to determine current patterns and quantity of usage of PCE drugs by healthy people. Furthermore, in order to instigate a dialogue between neuroethics and neuropsychopharmacology, we urge scientists to explore and communicate the social and ethical implications of their research to the public. Finally, we discuss and highlight other means of enhancing cognition in both patients and healthy adults, including education and physical exercise.

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Burden of schizophrenia in recently diagnosed patients: healthcare utilisation and cost perspective

Abstract: Only commercially insured patients and direct medical costs were included, therefore, results may underestimate the economic burden of schizophrenia.

Cited by 80 publications

References 42 publications

Impact of atypical long-acting injectable versus oral antipsychotics on rehospitalization rates and emergency room visits among relapsed schizophrenia patients: a retrospective database analysis

Impact of atypical long-acting injectable versus oral antipsychotics on rehospitalization rates and emergency room visits among relapsed schizophrenia patients: a retrospective database analysis

The threshold rate of oral atypical anti-psychotic adherence at which paliperidone palmitate is cost saving

The ethics of elective psychopharmacology

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