Cost‐effectiveness of treating first‐episode psychosis: five‐year follow‐up results from an Italian early intervention programme

Cocchi, Angelo; Mapelli, Vittorio; Meneghelli, Anna; Preti, Antonio

doi:10.1111/j.1751-7893.2011.00261.x

Cited by 43 publications

(44 citation statements)

References 41 publications

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“…The total economic burden of schizophrenia is comparable to the total costs of any other mental disorder. In most of the developed countries, current healthcare expenditure on schizophrenia accounts for 1.6% to 2.5% of the total healthcare budget [5,6]. Schizophrenia is a chronic mental illness associated with a significant and long-lasting health, social, and financial burden due to expenditures for hospitalization, treatment and rehabilitation, reduced and lost productivity [5-10].…”

Section: Introductionmentioning

confidence: 99%

An investigation of economic costs of schizophrenia in two areas of China

Zhai

Guo

Chen

et al. 2013

Int J Ment Health Syst

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BackgroundSchizophrenia is a severe psychotic disorder characterized by significant disturbances in thinking, perception, emotions and behavior. Even if it is not a very frequent disorder, but it is the most burdensome and costly illnesses worldwide. The total population was approximate 1.3 billion and there are approximate 8 million schizophrenic patients in China. Despite the wide-ranging financial and social burdens associated with schizophrenia, but there have been few cost-of-illness studies of this illness in China.ObjectiveTo evaluate the economic cost of schizophrenic patients in China.Methodology356 schizophrenic patients who met with DSM-IV criteria were enrolled and investigated with the Economic Burden Questionnaire(EBQ), 299 schizophrenic patients completed the study for 12 months. All the data were combined and classified by researcher. EBQ include all kinds of cost such as direct cost, indirect cost and total cost as well. It was filled in by patients and their close caregivers. Comparison of cost was made between not only out-patients and in-patients but also urban patients and rural patients. Multiple stepwise regression analysis was made to identify the main influence factors of total cost.Results(i) The per case per annum total costs, direct costs and indirect costs of schizophrenia amounted to US$2586.21, US$862.81(33.4%) and US$1723.40(66.6%) respectively. The per case total cost, direct cost and direct medical cost of in-patients were more higher than out-patients (P < 0.05). (ii) There was significant difference in per case per annum total cost, direct cost, direct medical cost, cost due to lost working-days and disability between urban and rural schizophrenic patients (P < 0.05), the former is higher than the latter. (iii) The results of multivariate stepwise regression analysis show that five variables were significantly correlated with higher cost: professional status(cadre), diagnostic subtype(residual schizophrenia), urban or rural patients(urban patients), in-patients or out-patients(in-patients) and researcher centre(southern center). The standardized regression coefficient were 0.308, 0.218, 0.212, 0.156 and 0.149 respectively, the correlation of determination R square was 0.2741, F = 15.651, P < 0.0000. These characteristics explain 27.41% of the variability in the total cost.Conclusion(i) Economic cost of schizophrenia were serious, we must pay close attention to it. (ii) The indirect cost are the majority of the total cost. The cost of urban patients are more higher than the cost of rural patients, the cost of in-patients are more higher than the cost of out-patients.

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Section: Introductionmentioning

confidence: 99%

An investigation of economic costs of schizophrenia in two areas of China

Zhai

Guo

Chen

et al. 2013

Int J Ment Health Syst

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“…26 Η Programma 2000 στο Μιλάνο ανέδειξε σε μια πενταετία σημαντικά οικονομικά οφέλη στο σύστημα Υγείας σε σχέση με τη συνήθη υποστήρι ξη ασθενών. 21 Στη Δανία η σχέση κόστους/οφέλους για το Εθνικό Σύστημα Υγείας από την εφαρμογή του προγράμματος ΕΠΨ OPUS αποτυπώθηκε από τους 29 Οι συγγραφείς καταγράφουν αυξημένα οφέλη, αλλά και κόστος από την εφαρμο γή του προγράμματος και καταλήγουν πως τα οφέλη όταν μεταφράζονται σε μακροπρόθεσμους ποιοτι κούς δείκτες και κατά συνέπεια σε οικονομικούς, υ περκαλύπτουν το κόστος του προγράμματος.…”

Section: το οικονομικό επιχείρημαunclassified

A proposal for the implementation of Early Intervention in Psychosis (EIP) services in Greece: If not now, when?

et al. 2018

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Ο ι διαταραχές του ευρύτερου ψυχωτικού φάσματος, με σοβαρότερη μορφή αυτή της σχιζοφρέ νειας, είναι συχνές και επηρεάζουν αναπόφευκτα την ποιότητα ζωής των πασχόντων και των οι κογενειών τους. Σκοπός του παρόντος άρθρου είναι να επισημανθεί η ανάγκη υιοθέτησης μιας διαφορετικής εθνικής στρατηγικής στην αντιμετώπιση των ψυχωτικών διαταραχών, βασισμένης στις αρχές της παροχής κοινοτικών υπηρεσιών έγκαιρης παρέμβασης στην ψύχωση (ΕΠΨ), που συνιστούν τις ταχύτερα αναπτυσσόμενες διεθνώς κοινοτικά προσανατολισμένες υπηρεσίες στον χώρο της Ψυχικής Υγείας. Αν και η παρακολούθηση σε εξωνοσοκομειακές δομές θεωρείται επαρκής, επιβάλλεται να υιοθε τηθεί πλέον μια πιο εμπεριστατωμένη και ολιστική αντιμετώπιση των αναγκών των νέων ασθενών και των οικογενειών τους, που τα παρόντα συστήματα ψυχικής υγείας αδυνατούν να καλύψουν, όπως διαφαίνεται από τα υψηλότατα ποσοστά υποτροπών των νέων ασθενών και τη σοβαρή επιβάρυνση στην καθημερινή τους λειτουργικότητα. Σε συνάφεια με τη διεθνή πραγματικότητα, προτείνεται η θεσμοθέτηση, σύσταση και εφαρμογή κοινοτικών υπηρεσιών ΕΠΨ που αφενός αποβλέπουν στην ενημέρωση/ευαισθητοποίηση

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“…The costs for patients, their families and society are huge, and largely generated by the direct cost of care, especially hospitalization [5-7]. Even higher costs arise from lost productivity (unemployment of patients and absence from work by the relatives who care for them), informal care, criminal justice service involvement, and social security expenditure [8,9].…”

Section: Introductionmentioning

confidence: 99%

Study on psychoeducation enhancing results of adherence in patients with schizophrenia (SPERA-S): study protocol for a randomized controlled trial

Петретто

Preti

Zuddas

et al. 2013

Trials

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BackgroundPoor adherence to pharmacotherapy negatively affects the course and the outcome of schizophreniaspectrum psychoses, enhancing the risk of relapse. Falloon and coworkers developed a Psychoeducation Program aimed at improving communication and problem-solving abilities in patients and their families. This study set out to evaluate changes in adherence to pharmacotherapy in patients diagnosed with schizophrenia-spectrum psychoses, by comparing one group exposed to the Falloon Psychoeducation Program (FPP) with another group exposed to family supportive therapy with generic information on the disorders.Methods340 patients diagnosed with schizophrenia and related disorders according to standardized criteria from 10 participating units distributed throughout the Italian National Health System (NHS), will be enrolled with 1:1 allocation by the method of blocks of randomized permutations. Patients will be reassessed at 6, 12 and 18 months after start of treatment (duration: 6 months).The primary objective is to evaluate changes in adherence to pharmacotherapy after psychoeducation. Adherence will be assessed at three-month intervals by measuring blood levels of the primary prescribed drug using high pressure liquid chromatography, and via the Medication Adherence Questionnaire and a modified version of the Adherence Interview. Secondary objectives are changes in the frequency of relapse and readmission, as the main indicator of the course of the disorder.Enrolled patients will be allocated to the FPP (yes/no) randomly, 1:1, in a procedure controlled by the coordinating unit; codes will be masked until the conclusion of the protocol (or the occurrence of a severe negative event). The raters will be blind to treatment allocation and will be tested for blinding after treatment completion. Intention-to-treat will be applied in considering the primary and secondary outcomes. Multiple imputations will be applied to integrate the missing data. The study started recruitment in February 2013; the total duration of the study is 27 months.DiscussionIf the psychoeducation program proves effective in improving adherence to pharmacotherapy and in reducing relapse and readmissions, its application could be proposed as a standard adjunctive psychosocial treatment within the Italian NHS.Trial registrationProtocol Registration System of ClinicalTrials.gov NCT01433094; registered on 20 August 2011; first patient was randomized on 12 February 2013.

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Cost‐effectiveness of treating first‐episode psychosis: five‐year follow‐up results from an Italian early intervention programme

Abstract: Allocation of funds to specialized early intervention programmes is the best alternative, as it can save costs by reducing the use of hospitals and residential facilities, and may produce net savings of costs in the long term.

Cited by 43 publications

References 41 publications

An investigation of economic costs of schizophrenia in two areas of China

An investigation of economic costs of schizophrenia in two areas of China

A proposal for the implementation of Early Intervention in Psychosis (EIP) services in Greece: If not now, when?

Study on psychoeducation enhancing results of adherence in patients with schizophrenia (SPERA-S): study protocol for a randomized controlled trial

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