Changes in adherence and treatment costs following initiation of oral or depot typical antipsychotics among previously non-adherent patients with schizophrenia

Hum Psychopharmacol. 2013 Sep;28(5):438-46. doi: 10.1002/hup.2328. Epub 2013 Jun 15.

Abstract

Objective: This study assessed the impact of depot formulations on adherence and treating costs in the naturalistic treatment of previously non-adherent outpatients with schizophrenia.

Methods: Data were taken from the European Schizophrenia Outpatient Health Outcomes (SOHO) study. Medication adherence and treating costs during an 18-month follow-up were assessed and compared for non-adherent patients initiated on depot typical (n = 262) or oral typical antipsychotics (n = 169) as monotherapy at the index visit. Multivariate analyses were employed to adjust for differences between the two groups at the index visit.

Results: Of the previously non-adherent patients, more than half of patients initiated on depot typicals (55%) remained adherent to medication during follow-up, whereas the equivalent was 39% for patients initiated on oral typicals. Logistic regression also showed higher odds of being adherent among the former group (Odds ratio = 1.84; 95% CI = 1.19-2.85). In addition, total costs incurred by this group during 18 months were only half those incurred by patients initiated on oral typicals (£3645 vs £7817, p < 0.05) CONCLUSIONS: Depot formulations of typical antipsychotics appeared to improve medication adherence and reduce treatment costs, compared with oral formulations, in the treatment of non-adherent patients.

Limitation: adherence was assessed by the treating psychiatrist using a single-item.

Keywords: adherence; antipsychotic; cost; non-adherence; schizophrenia.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Ambulatory Care / economics
  • Ambulatory Care / trends*
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / economics
  • Delayed-Action Preparations
  • Europe / epidemiology
  • Female
  • Health Care Costs*
  • Humans
  • Internationality
  • Male
  • Medication Adherence*
  • Middle Aged
  • Patient Compliance
  • Prospective Studies
  • Schizophrenia / drug therapy*
  • Schizophrenia / economics
  • Schizophrenia / epidemiology
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations