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The impact of non-adherence to medication in patients with schizophrenia on health, social care and societal costs. Analysis of the QUATRO study

Published online by Cambridge University Press:  10 April 2013

D. King ,
M. Knapp ,
A. Patel ,
F. Amaddeo ,
M. Tansella ,
A. Schene ,
M. Koeter ,
M. Angermeyer  and
T. Becker
D. King*
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
M. Knapp
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King's College London, London, UK
A. Patel
Affiliation:
Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King's College London, London, UK
F. Amaddeo
Affiliation:
Section of Psychiatry and Clinical Psychology, Department of Medicine and Public Health, University of Verona, Italy
M. Tansella
Affiliation:
Section of Psychiatry and Clinical Psychology, Department of Medicine and Public Health, University of Verona, Italy
A. Schene
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, The Netherlands
M. Koeter
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, The Netherlands
M. Angermeyer
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
T. Becker
Affiliation:
Department of Psychiatry II, University of Ulm, Ulm, Germany Bezirkskrankenhaus Guenzburg, Guenzburg, Germany
*
*Address for correspondence: Dr D. King, Personal Social Services Research Unit, LSE Health and Social Care, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK. (Email: d.king@lse.ac.uk)
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Abstract

Aims.

For people with schizophrenia, non-adherence to antipsychotic medications may result in high use of health and other services. The objective of our research was to examine the economic consequences of non-adherence in patients with schizophrenia taking antipsychotic medication.

Methods.

Data were taken from QUATRO, a randomized controlled trial that drew a sample of adults with schizophrenia receiving psychiatric services in four European cities: Amsterdam, Leipzig, London and Verona. Trial inclusion criteria were a clinical diagnosis of schizophrenia, requiring on-going antipsychotic medication for at least 1-year following baseline assessment, and exhibiting evidence of clinical instability in the year prior to baseline. The patient-completed Medication Adherence Questionnaire (MAQ) was used to calculate the 5-point Morisky index of adherence. Generalized linear models (GLM) were developed to determine the effect of adherence on (i) health and social care and (ii) societal costs before and after treatment, taking into account other potential cost-influencing factors.

Results.

The effect of non-adherence on costs was mixed. For different groups of services, and according to treatment group assignment, non-adherence was both negatively and positively associated with costs.

Conclusions.

The impact of non-adherence on costs varies across the types of services used by individuals with schizophrenia.

Keywords

CostsEuropenon-adherenceschizophrenia
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 23 , Issue 1 , March 2014 , pp. 61 - 70
Copyright
Copyright © Cambridge University Press 2013 

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