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The Schizophrenia Outpatient Health Outcomes (SOHO) study: 3-year results of antipsychotic treatment discontinuation and related clinical factors in Spain

Published online by Cambridge University Press:  16 April 2020

Antonio Ciudad ,
Josep María Haro ,
Jordi Alonso ,
Manuel Bousoño ,
David Suárez ,
Diego Novick  and
Inmaculada Gilaberte
Antonio Ciudad*
Affiliation:
Clinical Research, Department of Research and Development, Lilly, S.A. Avda. de la Industria, 30, 28108Alcobendas (Madrid), Spain
Josep María Haro
Affiliation:
Fundación San Juan de Dios, 08830 Sant Boi de Llobregat, Barcelona, Spain
Jordi Alonso
Affiliation:
Health Sciences Research Unit, IMIM – Hospital del Mar, 08003Barcelona, Spain
Manuel Bousoño
Affiliation:
Department of Psychiatry, University of Oviedo, 33006 Oviedo, Asturias, Spain
David Suárez
Affiliation:
Fundación San Juan de Dios, 08830 Sant Boi de Llobregat, Barcelona, Spain
Diego Novick
Affiliation:
European Health Outcomes Research, Eli Lilly and Company Limited, Windlesham, Surrey, UK
Inmaculada Gilaberte
Affiliation:
Clinical Research, Department of Research and Development, Lilly, S.A. Avda. de la Industria, 30, 28108Alcobendas (Madrid), Spain
*
*Corresponding author. Tel.: +34 91 663 50 00. E-mail address: ciudad_antonio@lilly.com (A. Ciudad).
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Abstract

Introduction

This article presents the long-term results in terms of antipsychotic medication maintenance and factors influencing it in a representative sample of patients with schizophrenia recruited in the SOHO study within Spain.

Methods

The SOHO was a prospective, 3-year observational study of the outcomes of schizophrenia treatment in outpatients who initiated therapy or changed to a new antipsychotic performed in 10 European countries with a focus on olanzapine. The Kaplan–Meier method was used to analyse the time to treatment discontinuation and the Cox proportional hazards model to investigate correlates of discontinuation.

Results and conclusions

In total, 1688 patients were included in the analyses. Medication maintenance at 3 years varied with the antipsychotic prescribed, being highest with clozapine (57.6%, 95% CI 39.2–74.5), followed by olanzapine (48.3%, 95% CI 45.1–51.5); and lowest with quetiapine (19.0%, 95% CI 13.0–26.3). Treatment discontinuation was significantly less frequent with olanzapine than with risperidone (p = 0.015), depot typical (p = 0.001), oral typical antipsychotics (p < 0.001) or quetiapine (p < 0.001); but not than with clozapine (p = 0.309). Longer maintenance was also associated with higher social abilities and better cognitive status at baseline; in contrast, a shorter time to discontinuation was associated with the need for mood stabilisers during follow-up. This study emphasises the different value of antipsychotics in day-to-day clinical practice, as some of them were associated with longer medication maintenance periods than others. This study has some limitations because of possible selection and information biases derived from the non-systematic, non-randomised allocation to treatments and the existence of unobserved covariates that may influence the outcome.

Keywords

SchizophreniaAntipsychotic agentsOutcome assessmentHealth care surveysProspective studies
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 1 , January 2008 , pp. 1 - 7
Copyright
Copyright © Elsevier Masson SAS 2008

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