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Baseline characteristics and initial treatment decisions for patients with schizophrenia at risk of treatment nonadherence

Authors Kelin K, Brnabic AJ, Newton R, Escamilla RI, Chuo L, Simu M, Ye W, Montgomery W, Karagianis J, Ascher-Svanum H

Published 11 August 2010 Volume 2010:4 Pages 301—311


Review by Single anonymous peer review

Peer reviewer comments 2

Katarina Kelin1, Alan JM Brnabic2, Richard Newton3, Raúl I Escamilla4, Liang-Jen Chuo5, Malina Simu6, Wenyu Ye2, William Montgomery1, Jamie Karagianis7, Haya Ascher-Svanum8
1Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 2Intercontinental Information Sciences, Eli Lilly Australia Pty Ltd, Macquarie Park, NSW, Australia; 3Peninsula Health Psychiatric Services, Frankston Hospital, Frankston, VIC, Australia (current affiliation: Department of Psychiatry, Austin Hospital, Heidelberg, VIC, Australia); 4Schizophrenia Clinic, National Institute of Psychiatry, Mexico City, México D.F; 5Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; 6St Stelian Hospital, Bucharest, Romania; 7Eli Lilly Canada Inc., Toronto, ON, Canada; 8US Outcomes Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA

Abstract: In this year-long, prospective observational study, sociodemographic, clinical, and functional characteristics were assessed in outpatients with schizophrenia from Australia, ­Mexico, Romania, and Taiwan who were switched from their primary oral antipsychotic to another oral or depot antipsychotic at study entry because of physician-perceived ­nonadherence risks. Patients (N = 406) rated their quality of life and functioning level as low. Few patients (10.6%, 43/406) were switched to depot antipsychotics, with country-specific differences (P < 0.001). Although illness severity was similar between subgroups, the depot switch ­subgroup had: a documented history of nonadherence (32.6% versus oral: 4.7%); recent alcohol (48.8% versus 23.2%; P < 0.001) or illicit drug use (16.3% versus 5.0%; P = 0.010); recent depot antipsychotic (20.7% versus 7.5%; P = 0.030) and mood stabilizer use (51.7% versus 26.3%; P = 0.008); poorer attitudes towards medication (P = 0.004); and poorer illness ­awareness (P = 0.041). Findings indicate that even when a risk of nonadherence has been identified, few patients with schizophrenia receive depot antipsychotics, despite being prime candidates for depot therapy. Findings suggest physicians may select depot therapy based on previous ­nonadherence, substance use, recent depot antipsychotic and mood stabilizer use, poor attitudes towards medications, and poor illness awareness.

Keywords: antipsychotic drugs, schizophrenia, depot antipsychotic, nonadherence

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