Impact of Early Nonadherence to Oral Antipsychotics on Clinical and Economic Outcomes Among Patients with Schizophrenia

Offord, Steve J.; Lin, Jay; Mirski, Dario; Wong, Bruce

doi:10.1007/s12325-013-0016-5

Cited by 61 publications

(60 citation statements)

References 25 publications

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“…This is important as dysregulation of the normal myelination trajectory may contribute to the functional deterioration and treatment resistance observed in chronic schizophrenia [139]. The clinical imperative to reduce relapse rates stems also from the added economic burden of treating relapse, possibly leading to unavoidable hospital admissions [134,[141][142][143][144][145][146][147]. Finally, relapses due to medication non-adherence can have devastating social consequences themselves.…”

Section: Results Of Descriptivementioning

confidence: 99%

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

et al. 2015

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With continuous treatment, patients have a lower risk of relapse and remain relapse free for a longer period of time compared with placebo and intermittent treatment strategies. Moreover, 'success rates' in the intermittent treatment conditions are expected to be an overestimate of actual outcome rates. Therefore, continuous treatment remains the 'gold standard' for good clinical practice, particularly as, until now, only a few and rather general valid predictors for relapse in schizophrenia are known and subsequent relapses may contribute to functional deterioration as well as treatment resistance in patients with schizophrenia.

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Section: Results Of Descriptivementioning

confidence: 99%

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

et al. 2015

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“…Commonly cited reasons for nonadherence to antipsychotic treatment include substance abuse, poor illness insight, cognitive deficits, lack of social support, poor therapeutic alliance, practical problems (i.e., financial, environmental, lack of routine), and problematic side effects (4). Partial or complete nonadherence to antipsychotic medications is associated with numerous adverse outcomes, including exacerbation of psychotic symptoms and increased risk of relapse, impaired functioning, increased suicide attempts, increased hospital and emergency room use, and high healthcare costs (5–7). …”

Section: Introductionmentioning

confidence: 99%

Development and Feasibility Testing of a Smartphone Intervention to Improve Adherence to Antipsychotic Medications

Kreyenbuhl¹,

Record²,

Himelhoch³

et al. 2019

Clinical Schizophrenia & Related Psychoses

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Approximately 60% of individuals with schizophrenia do not take their antipsychotic medications as prescribed, and nonadherence is associated with exacerbation of psychotic symptoms, increased hospital and emergency room use, and increased healthcare costs. Behavioral-tailoring strategies that incorporate medication taking into the daily routine and use environmental supports have shown promise as adherence-enhancing interventions. Informed by the Information-Motivation-Behavioral (IMB) Skills Model and using the iterative process of user-centered design, we collaborated with individuals with schizophrenia and psychiatrists to develop an interactive smartphone application and web-based clinician interface, MedActive, for improving adherence to oral antipsychotic treatment. MedActive facilitates the active involvement of individuals with schizophrenia in managing their antipsychotic medication regimen by providing automated reminders for medication administration and tailored motivational feedback to encourage adherence, and by displaying user-friendly results of daily ecological momentary assessments (EMAs) of medication adherence, positive psychotic symptoms, and medication side effects for individuals and their psychiatrists. In a 2-week open trial completed by 7 individuals with schizophrenia and their psychiatrists, MedActive was determined to be both feasible and acceptable, with patient participants responding to 80% of all scheduled EMAs and providing positive evaluations of their use of the application. Psychiatrist participants were interested in viewing the information provided on the MedActive clinician interface, but cited practical barriers to regularly accessing it and integrating into their daily practice.

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“…Similar results were reported in a nationwide cross-sectional survey of patients who were treated with a prescription medication for schizophrenia-patients who were completely adherent to their medication were significantly less likely to report a mental-health-related or non-mental-health-related hospitalization 6 . Long-acting injectable (LAI) antipsychotics provide an effective and important treatment option that alleviates the burden of daily dosing, which may improve adherence 7 ; recent estimates of oral antipsychotic nonadherence in patients with schizophrenia were as high as 60% early in the course of treatment (ie, within 90 days of filling their earliest prescription) 8 .…”

Section: Introductionmentioning

confidence: 99%

Initiation of aripiprazole once-monthly in patients with schizophrenia

Raoufinia

Baker

Eramo

et al. 2015

Current Medical Research and Opinion

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Findings from PK data, PK simulations, and clinical studies all support that 400 mg is the appropriate initiation dose of AOM for patients with schizophrenia. When switching to oral aripiprazole before initiating AOM 400, tapering the prior oral antipsychotic while titrating up the oral aripiprazole dose (target dose 10-30 mg/d) over >1 to 4 weeks may be an effective strategy. The efficacy, safety, and tolerability of AOM 400 were comparable regardless of whether patients were previously stabilized on oral aripiprazole 10 or 30 mg/d or other antipsychotic therapy and continued to receive the same oral antipsychotic for the first 14 days after initiating AOM 400.

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Impact of Early Nonadherence to Oral Antipsychotics on Clinical and Economic Outcomes Among Patients with Schizophrenia

Abstract: Approximately 60% of patients with schizophrenia are nonadherent to antipsychotic medication early in treatment and are less likely to be adherent later. Early nonadherence resulted in more all-cause and schizophrenia-related hospitalizations with a greater LOS and cost of care.

Cited by 61 publications

References 25 publications

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

Development and Feasibility Testing of a Smartphone Intervention to Improve Adherence to Antipsychotic Medications

Initiation of aripiprazole once-monthly in patients with schizophrenia

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