Financial cost of treating out-patients with schizophrenia in Nigeria

Suleiman, Toyin G.; Ohaeri, Jude U.; Lawal, RA; Haruna, Adam Y.; Orija, O B

doi:10.1192/bjp.171.4.364

Cited by 49 publications

(45 citation statements)

References 13 publications

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“…This is in line with our finding that subjects with low occupational status were significantly more likely to experience psychiatric symptoms. First, this could be a reflection of the reported economic burden of DM in Nigeria (9,10,19). Second, it underscores the need for consistent efforts at health education for DM sufferers and a national policy of subsidising the cost of this very expensive illness in a severely distressed national economy.…”

Section: Discussionmentioning

confidence: 99%

Specific psychiatric moridity among diabetics at a Nigerian General Hospital

Coker¹,

Ohaeri²,

Lawal³

et al. 2009

E Af Med Jrnl

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Background:In Nigeria, with a rising incidence of diabetes mellitus (DM), there are no controlled studies of specific psychiatric morbidity among sufferers. Objective: To assess the prevalence of specific psychiatric disorders and general cognitive impairment in patients with diabetes mellitus. Method: Using Wing's Present State Examination and the Mini-Mental State Examination, we assessed the prevalence of specific psychiatric disorders and cognitive impairment among 100DM patients attending an out-patient clinic, in comparison with a matched non-clinic sample; and examined the relationship between psychiatric morbidity and clinical variables. Results: They were predominantly males (66%), mean age 43.0 years, mean duration of illness, 7.7 years and in low level occupations. Only 11 of the patients had sexual dysfunction (11%) and psychiatric symptoms (31%). Psychiatric diagnosis (ICD-10) were, generalised anxiety (6%) and mild depressive disorder (4%). Two had subjective memory disturbance. Insulin-dependent patients had significantly more widespread psychiatric symptoms than the non-insulin dependent. Psychiatric symptomatology was significantly associated with low occupational status, duration of illness and sexual dysfunction. Conclusion: Health education, subsidising the cost of treatment, and physicians' sensitivity to the emotional condition of patients, will help to relieve psychic distress and make for more adequate management.

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Section: Discussionmentioning

confidence: 99%

Specific psychiatric moridity among diabetics at a Nigerian General Hospital

Coker¹,

Ohaeri²,

Lawal³

et al. 2009

E Af Med Jrnl

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“…Unfortunately, healthcare services, including mental health services, are largely provided on an out-of-pocket basis and there are no national social welfare schemes in Nigeria for patients with chronic mental illnesses, placing the financial burden of care on patients' relatives. 15 Hence, previous researchers in Nigeria have suggested a decentralization of psychiatric services and facilities through the establishment of functional community psychiatric practice as possible solution to reducing non-attendance rates in outpatient clinics. 5,16 Outpatient clinic defaulters in this study also had significantly higher scores on the Brief Psychiatric Rating Scale, and thus more severe psychopathologies than non-defaulters.…”

Section: Discussionmentioning

confidence: 99%

Pattern of attendance and predictors of default among Nigerian outpatients with schizophrenia

Adelufosi¹,

Ogunwale²,

Adeponle³

et al. 2013

Afr. J. Psych

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Objective: To assess the pattern of and factors associated with outpatient clinic attendance among patients diagnosed with schizophrenia at a Nigerian psychiatric hospital. Method: This was a cross-sectional descriptive study of 313 consecutive outpatients with diagnosis of schizophrenia confirmed with the Structured Clinical Interview for Diagnosis (SCID). Data was collected on sociodemographics, clinic attendance, perceived social support, perceived satisfaction with hospital care and illness severity (assessed using the Brief Psychiatric Rating Scale, BPRS). Logistic regression analysis was used to identify factors associated with outpatient clinic default. Results: Overall, 20.4% respondents were defaulters, with a median duration of clinic nonattendance of 8 weeks. Outpatient clinic defaulters had significantly higher BPRS scores and had missed more outpatient clinic appointments compared with non-defaulters. A significantly higher proportion of defaulters resided more than 20km away from the hospital and reported "not satisfied" with their outpatient care. Being financially constrained was the commonest reason given by defaulters for missing their clinic appointments. The significant predictors of outpatient clinic default included residing more than 20km from the hospital, missing previous appointments and dissatisfaction with outpatient care. Conclusion: Outpatient clinic non-attendance is common among patients with schizophrenia, and is significantly associated with demographic, clinical and service related factors. Interventions targeted at addressing the risk factors for defaulting peculiar to developing country settings similar to the location of this study, could significantly improve treatment outcome.

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“…Ogunbekun et al, [44] Konje at al., [45] [49] 1997 Cost analysis Tx of schizophrenia vs tx of diabetes mellitus Mean cost of tx of schizophrenia was $US35.90 per pt over 6 months; cost of schizophrenia was significantly less than that of diabetes ($US143.00 per pt)…”

Section: Continued Next Pagementioning

confidence: 99%

The State of Health Economic Evaluation Research in Nigeria

et al. 2010

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This study assessed the state of health economic evaluation (including pharmacoeconomic) research in Nigeria. A literature search was conducted to identify health economic articles pertaining to Nigeria. Two reviewers independently scored each article in the final sample using a data collection form designed for the study. A total of 44 studies investigating a wide variety of diseases were included in the review. These articles were published in 34 different journals, mostly based outside of Nigeria, between 1988 and 2009. On average, each article was written by four authors. Most first authors had medical/clinical affiliations and resided in Nigeria at the time of publication of the study. Based on a 1 to 10 scale, with 10 indicating the highest quality, the mean quality score for all studies was 7.29 (SD 1.21) and 59% of the articles were of fair quality (score 5-7); 5% were of even lower quality. The quality of articles was statistically significantly (p < or = 0.05) related to the country of residence of the primary author (non-Nigeria = higher), country of the journal (non-Nigeria = higher), primary objective of the study (economic analysis = higher) and type of economic analysis conducted (economic evaluations higher than cost studies). The conduct of health economic (including pharmacoeconomic) research in Nigeria was limited and about two-thirds of published articles were of sub-optimal quality. More and better quality health economic research in Nigeria is warranted.

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Financial cost of treating out-patients with schizophrenia in Nigeria

Abstract: Because of drastic currency devaluation, and lack of disability benefits and nursing homes, the findings contrast with Western reports where cost of drugs constitutes 2-5%, and indirect costs constitute over 50% of the total cost of schizophrenia.

Cited by 49 publications

References 13 publications

Specific psychiatric moridity among diabetics at a Nigerian General Hospital

Specific psychiatric moridity among diabetics at a Nigerian General Hospital

Pattern of attendance and predictors of default among Nigerian outpatients with schizophrenia

The State of Health Economic Evaluation Research in Nigeria

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