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首页> 外文期刊>Patient Preference and Adherence >Treatment patterns and health care resource utilization in a 1-year observational cohort study of outpatients with schizophrenia at risk of nonadherence treated with long-acting injectable antipsychotics
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Treatment patterns and health care resource utilization in a 1-year observational cohort study of outpatients with schizophrenia at risk of nonadherence treated with long-acting injectable antipsychotics

机译：长期观察性长效抗精神病药治疗精神分裂症门诊患者的治疗模式和卫生保健资源利用，为期1年

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Purpose: To describe (1) the clinical profiles and the patterns of use of long-acting injectable (LAI) antipsychotics in patients with schizophrenia at risk of nonadherence with oral antipsychotics, and in those who started treatment with LAI antipsychotics, (2) health care resource utilization and associated costs.Patients and methods: A total of 597 outpatients with schizophrenia at risk of nonadherence, according to the psychiatrist's clinical judgment, were recruited at 59 centers in a noninterventional prospective observational study of 1-year follow-up when their treatment was modified. In a post hoc analysis, the profiles of patients starting LAI or continuing with oral antipsychotics were described, and descriptive analyses of treatments, health resource utilization, and direct costs were performed in those who started an LAI antipsychotic.Results: Therapy modifications involved the antipsychotic medications in 84.8% of patients, mostly because of insufficient efficacy of prior regimen. Ninety-two (15.4%) patients started an LAI antipsychotic at recruitment. Of these, only 13 (14.1%) were prescribed with first-generation antipsychotics. During 1 year, 16.3% of patients who started and 14.9% of patients who did not start an LAI antipsychotic at recruitment relapsed, contrasting with the 20.9% who had been hospitalized only within the prior 6 months. After 1 year, 74.3% of patients who started an LAI antipsychotic continued concomitant treatment with oral antipsychotics. The mean (median) total direct health care cost per patient per month during the study year among the patients starting any LAI antipsychotic at baseline was €1,407 (€897.7). Medication costs (including oral and LAI antipsychotics and concomitant medication) represented almost 44%, whereas nonmedication costs accounted for more than 55% of the mean total direct health care costs.Conclusion: LAI antipsychotics were infrequently prescribed in spite of a psychiatrist-perceived risk of nonadherence to oral antipsychotics. Mean medication costs were lower than nonmedication costs.
机译：目的：描述（1）长效注射（LAI）抗精神病药在患有不坚持口服抗精神病药风险的精神分裂症患者以及开始使用LAI抗精神病药治疗的患者中的临床概况和使用方式，（2）健康患者和方法：根据精神病医生的临床判断，共有597名精神分裂症门诊患者存在非依从性风险，这些患者来自59个中心，进行了为期1年随访的非干预性前瞻性观察研究。治疗进行了修改。在事后分析中，描述了开始使用LAI或继续口服抗精神病药的患者的概况，并对开始使用LAI抗精神病药的患者进行了治疗，健康资源利用和直接费用的描述性分析。结果：治疗修改涉及抗精神病药84.8％的患者服用药物，主要是因为先前方案的疗效不足。九十二名（15.4％）患者在招募时开始进行LAI抗精神病药治疗。在这些药物中，只有13种（14.1％）被处方使用第一代抗精神病药。在1年内，开始招募的患者中有16.3％的患者开始复发，而在招募中没有开始LAI抗精神病药物的患者中有14.9％的患者复发，而仅在前6个月内住院的患者为20.9％。一年后，开始进行LAI抗精神病药的患者中有74.3％继续接受口服抗精神病药的伴随治疗。在研究年度中，在基线开始使用任何LAI抗精神病药的患者中，每位患者每月平均直接医疗总费用（中位数）为1,407欧元（897.7欧元）。药物治疗费用（包括口服和LAI抗精神病药及伴随用药）几乎占44％，而非药物治疗费用占直接直接医疗总平均费用的55％以上。结论：尽管有精神病医生认为有风险，但仍很少开具LAI抗精神病药。不坚持口服抗精神病药。平均用药成本低于非用药成本。

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