Health outcomes of schizophrenia in Thailand: Health care provider and patient perspectives

Phanthunane, Pudtan; Vos, Theo; Whiteford, Harvey; Bertram, Melanie

doi:10.1016/j.ajp.2010.09.004

Cited by 3 publications

(10 citation statements)

References 27 publications

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“…Providing clozapine instead of risperidone to the most severe one-third of patients has an ICER of 320,000 baht/DALY (95% CI: 26,000, "dominated"; 51% probability of a result below the three times GDP per capita threshold of 330,000 baht/DALY for cost-effective interventions). We assumed that patients who had a score greater than 40 on the BPRS (this would include about one-third of patients in our survey) would be eligible for clozapine [ 20 , 31 ]. "Dominated" denotes an intervention more costly and less effective than the comparator, while "dominant" means the intervention is more effective and less costly than the comparator.…”

Section: Resultsmentioning

confidence: 99%

“…The standardized effect sizes were then pooled using the random effects meta-analysis method to deal with variation around some overall average treatment effect [ 23 ]. The method used in the Australian Assessing Cost Effectiveness - Mental Health (ACE-MH) project [ 22 , 24 ] to transfer the pooled effect sizes into a change in disability weight was adjusted to include the spread of the Brief Psychiatric Rating Scale-Expanded (BPRS-E) scores from our survey, a cross-sectional descriptive study including 307 people with schizophrenia in Thailand (279 outpatients and 28 inpatients) [ 20 , 31 ]. We mapped each BPRS-E score (ranging from 24 = least severe to 134 = most severe) to the Dutch lowest and highest DWs for schizophrenia (0.21-0.98) using the methods developed by the ACE-MH Study [ 24 , 32 ].…”

Section: Methodsmentioning

confidence: 99%

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Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Phanthunane

Vos

Whiteford

et al. 2011

Cost Eff Resour Alloc

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BackgroundInformation on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand.MethodsA Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken.ResultsGeneric risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita.ConclusionsThere are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine may be dominated and there are serious side effects, treating severe patients with clozapine is advisable only for patients who do not respond to risperidone and only in the presence of a stricter side effect monitoring system than currently exists.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Phanthunane

Vos

Whiteford

et al. 2011

Cost Eff Resour Alloc

Self Cite

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“…Schizophrenia is also one of the most financially debilitating illnesses (Phanthunane et al, 2010;Soygür, 2003). When considering only the disability component in the calculation of the burden of disease, mental illnesses account for around 30% of all years lived with a disability (YLD) in low-and middle-income countries (World Health Organization, 2011).…”

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confidence: 99%

“…Approximately one in every 100 people is diagnosed with schizophrenia worldwide (Lobban, Barrowclough, & Jones, 2005); however, when one also includes patients' friends and family members, the number of people who are affected by this illness is much higher. Schizophrenia not only affects an individual's psychological, occupational and social functions (Mwansisya et al, 2013) but also is accompanied by complex disruptions in emotions, thoughts and perceptions (Graor & Knapik, 2013;Phanthunane, Vos, Whiteford, & Bertram, 2010). The literature shows that individuals with serious mental illnesses such as schizophrenia experience difficulty accessing mental health services.…”

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confidence: 99%

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Illness Perception in Turkish Schizophrenia Patients: A Qualitative Explorative Study

Güner

2014

Archives of Psychiatric Nursing

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Mental health recovery for people with schizophrenia in Southeast Asia: A systematic review

Murwasuminar

Munro

Récoché

2023

Psychiatric Ment Health Nurs

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Accessible Summary What is Known on the Subject? Mental health recovery has become a more prevalent approach to empowering people with schizophrenia (PWS), especially in western countries. However, despite the benefits, there is a lack of evidence regarding its practice in developing countries such as Southeast Asian Countries. The optimal treatment for PWS has not yet been identified, since most mental health care is provided in hospital‐based settings in Southeast Asia. Mental health treatment in Southeast Asia is highly influenced by cultural norms, values, and practices. What the Paper Adds to Existing Knowledge? The findings highlight the importance of integrating cultural aspects into the treatment of people with schizophrenia. The sample of unique elements in Southeast Asian mental health recovery include using a close neighbour/cadre as social support and using religious activity to increase hope. Lack of government support, high level of employment, and stigma are the biggest barriers in the PWS recovery process. What is the Implication for Practice? There is a research gap regarding the awareness and implementation of mental health recovery in psychiatric programs across the Southeast Asian region which likely impacts the effectiveness of the treatment. The review shows that little research has explored the concept of personal recovery in Southeast Asian Countries. Abstract Introduction Recovery has become an important approach used by mental health services around the world. Many mental health systems have taken steps to move towards more recovery‐oriented practices and service delivery. Therefore, establishing recovery‐oriented services in developing countries like those in the Southeast Asian region requires a detailed understanding of the cultural norms, values, and current mental health practices. Aims To investigate the mental health practices that promote recovery, its barrier in Southeast Asia, and to determine if they align with the CHIME recovery model. Method Electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and SCOPUS, were searched [PROSPERO] (CRD42021227962). Peer‐reviewed English language articles from 2004 to January 2021 were included. Methodological quality was assessed using the CASP checklist, and thematic synthesis of included studies was conducted. Results Thirty‐one studies met inclusion criteria. Several themes illustrated mental health recovery services and the current obstacles identified in South‐east Asian studies. Connection includes peer support and support groups, relationship status, and limited opportunities to become involved in the community. Hope is found in cultural concepts of hope, stimulating recovery through mental health programs, whilst lack of knowledge and education are the main barriers. Ethnicity is linked to a high level of stigma, but ethnicity also builds identity. Meaning and spirituality manifest in religious activities as the catalyst for recovery. Finally, the opposite of Empowerment is seen in the tendency of people with schizophren...

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Health outcomes of schizophrenia in Thailand: Health care provider and patient perspectives

Cited by 3 publications

References 27 publications

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Illness Perception in Turkish Schizophrenia Patients: A Qualitative Explorative Study

Mental health recovery for people with schizophrenia in Southeast Asia: A systematic review

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