Treatment persistence: a comparison among patients with schizophrenia who were initiated on atypical antipsychotic agents

Ren, Xinhua S.; Qian, Shirley; Lee, A. F.; Herz, Lawrence; Miller, Donald R.; Kazis, Lewis E.

doi:10.1111/j.1365-2710.2006.00711.x

Cited by 15 publications

(14 citation statements)

References 29 publications

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“…Over the past two decades, interest has increased in studies on treatment persistence with antipsychotic agents (Lehman and Steinwachs 1998; Valenstein et al 2002; Lehman et al 2004; Lieberman et al 2005; Ren et al 2006). A number of studies have reported that poor treatment persistence with antipsychotic agents is a common problem among patients with schizophrenia (Docherty et al 2003; Tafesse et al 2003), which results in relapse of schizophrenic symptoms, increased outpatient visits, hospital admissions, and associated unnecessary medical expenses (Grogg et al 2002; Lacro et al 2002; Docherty et al 2003; Tafesse et al 2003).…”

Section: Discussionmentioning

confidence: 99%

“…However, the likelihood of sustaining control of schizophrenic symptoms depends on the persistence of treatment (Vanelli et al 2001; Menzin et al 2003). The importance of sustained treatment in the clinical management of schizophrenia, coupled with known differential side effects associated with typical and atypical antipsychotic agents (Kane 1996; Allison et al 1999; Leucht et al 1999; Leslie and Rosenheck 2001), has generated a lot of interest in comparing treatment persistence across antipsychotic agents (APA 1997; Lehman and Steinwachs 1998; VA 1998; Valenstein et al 2002; Docherty et al 2003; Lehman et al 2004; Lieberman et al 2005; Ren et al 2006). …”

Section: Introductionmentioning

confidence: 99%

“…Recognizing the importance of treatment persistence in controlling symptoms of schizophrenia, a number of studies have compared levels of treatment persistence across different antipsychotic agents (Cramer and Rosenheck 1999; Dixon et al 1999; Vanelli et al 2001; Dolder et al 2002; Zhu et al 2003; Ren et al 2006). However, the results of these studies tend to be mixed.…”

Section: Introductionmentioning

confidence: 99%

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An alternative approach to measuring treatment persistence with antipsychotic agents among patients with schizophrenia in the Veterans Health Administration

Ren¹,

Qian²,

Kazis³

2007

Neuropsychiatric Disease and Treatment

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Prior studies have demonstrated the importance of treatment persistence with antipsychotic agents in sustaining control of schizophrenic symptoms. However, the conventional approach in measuring treatment persistence tended to use only the fi rst prescription episode even though some patients received multiple prescriptions (or multiple treatment episodes) of the same medication within one year following the initiation of the index drug. In this study, we used data from the Veterans Health Administration in the United States to assess the extent to which patients received multiple prescriptions. The study found that about a quarter of the patients had two or more treatment episodes and that levels of treatment persistence tended to vary across treatment episodes. Based on these results, we offered an alternative approach in which we calculated treatment persistence with typical and atypical antipsychotic agents separately for patients with one, two, or three treatment episodes. Considering that patients with different number of treatment episodes might differ in disease profi les, this treatment episode-specifi c approach offered a fair comparison of the levels of treatment persistence across patients with different number of treatment episodes. Future research needs to extend the analyses beyond two antipsychotic classes to individual antipsychotic agents. A more comprehensive assessment using appropriate analytic methods should help physicians make prescription choices that will ultimately improve the care of patients with schizophrenia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An alternative approach to measuring treatment persistence with antipsychotic agents among patients with schizophrenia in the Veterans Health Administration

Ren¹,

Qian²,

Kazis³

2007

Neuropsychiatric Disease and Treatment

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“…Ren et al [41] assessed differences in persistence between groups of patients initiated on olanzapine (n ¼ 3570) or risperidone (n ¼ 3574) in the Veterans Administration system, based on the frequency of switching within the first 2 months of treatment. The results indicated that olanzapine use was associated with better persistence.…”

Section: Data Supporting Improved Compliance With New Antipsychotic Dmentioning

confidence: 99%

New generation antipsychotic drugs and compliance behaviour

Voruganti

Baker²,

Awad³

2008

Current Opinion in Psychiatry

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A decade of clinical experience and research indicates that compliance behaviour has only marginally improved since the introduction of second generation antipsychotic drugs. Noncompliance in schizophrenia is a complex maladaptive pattern of behaviour determined by personal beliefs, illness-related factors, social attributes and health system variables. The reinforcing value of antipsychotic drugs may be less relevant in enhancing treatment compliance and influencing the natural history of schizophrenia.

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“…However, the likelihood of sustaining control of schizophrenic symptoms depends on treatment adherence with antipsychotic agents by the patients 3,4. The importance of sustained medication treatment in the management of schizophrenia, coupled with known differential side effects associated with typical and atypical antipsychotic agents,5–8 has generated a lot of interest in the development of pharmacy-based measures to compare the levels of treatment adherence across different antipsychotic agents 9–17…”

Section: Introductionmentioning

confidence: 99%

Measurement of treatment adherence with antipsychotic agents in patients with schizophrenia

Ren

Herz²,

Qian³

et al. 2009

NDT

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The importance of medication adherence in sustaining control of schizophrenic symptoms has generated a great deal of interest in comparing levels of treatment adherence with different antipsychotic agents. However, the bulk of the research has yielded results that are often inconsistent. In this prospective, observational study, we assessed the measurement properties of 3 commonly used, pharmacy-based measures of treatment adherence with antipsychotic agents in schizophrenia using data from the Veterans Health Administration during 2000 to 2005. Patients were selected if they were on antipsychotics and diagnosed with schizophrenia (N = 18,425). A gap of ≥30 days (with no filled index medication) was used to define discontinuation of treatment as well as medication “episodes,” or the number of times a patient returned to the same index agent after discontinuation of treatment within a 1-year period. The study found that the 3 existing measures differed in their approaches in measuring treatment adherence, suggesting that studies using these different measures would generate different levels of treatment adherence across antipsychotic agents. Considering the measurement problems associated with each existing approach, we offered a new, medication episode-specific approach, which would provide a fairer comparison of the levels of treatment adherence across different antipsychotic agents.

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Treatment persistence: a comparison among patients with schizophrenia who were initiated on atypical antipsychotic agents

Cited by 15 publications

References 29 publications

An alternative approach to measuring treatment persistence with antipsychotic agents among patients with schizophrenia in the Veterans Health Administration

An alternative approach to measuring treatment persistence with antipsychotic agents among patients with schizophrenia in the Veterans Health Administration

New generation antipsychotic drugs and compliance behaviour

Measurement of treatment adherence with antipsychotic agents in patients with schizophrenia

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