Exploring the Impact of Schizophrenia and Its Pharmacological Treatment on Health-Related Quality of Life and Treatment Preferences

Abstract

Celso Arango,1 Inmaculada Baeza,2 Clemente García-Rizo,3 Benedicto Crespo-Facorro,4 Guillermo Lahera,5 Eduard Vieta,6 Frauke Becker,7 Georges Dwyer,7 Siobhan Bourke,7 Adam EJ Gibson,7 Irene Gabarda-Inat,8 Elena Alvarez-Baron8 1Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, Universidad Complutense, School of Medicine, Madrid, Spain; 2Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; 3Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona Spain; Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain; Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Medicine Department, Barcelona, Spain; 4Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, s/n, 41013, Sevilla, Spain; Centro Investigación Biomédica en Red Salud Mental, CIBERSAM, Madrid, Spain; Instituto de Biomedicina de Sevilla (IBiS), HUVR/CSIC/Universidad de Sevilla, Seville, Spain; Department of Psychiatry, Universidad de Sevilla, Seville, Spain; 5Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain; CIBERSAM, Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain; Principe de Asturias University Hospital, Alcalá, Spain; 6Department of Psychiatry and Psychology, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; 7Putnam Associates, Fitzrovia, London, England; 8Angelini Pharma España S.L.U. Global Medical Department, Barcelona, SpainCorrespondence: Georges Dwyer, Putnam Associates, 22-24 Torrington Place, Fitzrovia, London, WC1E 7HJ, England, Email [email protected]: Pharmacological treatments play an important role in managing symptoms of schizophrenia but can also be associated with side effects. The aim of this study was to understand the impact of schizophrenia and its pharmacological treatment on patients’ health-related quality of life (HRQoL) and to explore patient preferences around treatment benefits and side effects.Patients and Methods: This study employed a mixed methods approach with two stages of recruitment of adult patients in Spain. Stage 1 included qualitative and quantitative elements (including included two validated patient-reported outcome measures: PETiT and EQ-5D-5L) administered in telephone interviews with people with schizophrenia. Stage 2 consisted of a quantitative online survey completed by people with schizophrenia attending outpatient clinics. Responses to quantitative items across both stages were combined for analysis.Results: Twenty respondents completed the mixed methods interviews (stage 1), and 25 participants completed the online survey (stage 2). Results from stages 1 and 2, showed that participants perceived treatments to have a beneficial impact on controlling their symptoms. However, cognitive side effects were reported to have a detrimental impact on respondents’ daily life and were considered a primary reason for treatment cessation in the past. Qualitative findings further showed that most participants hoped future treatments would minimise the impact of cognitive symptoms of schizophrenia.Conclusion: The findings suggest that patients’ expectation around treatment efficacy and their acceptability of treatment side effects may indicate their capacity to maintain long-term treatment adherence. Trade-offs that patients may be willing to make between these components may prove useful to consider in clinical practice to improve treatment adherence and hence treatment effectiveness in people with schizophrenia.Keywords: schizophrenia, health-related quality of life, treatment burden, preferences

Keywords

• Schizophrenia
• health-related quality of life
• treatment burden
• preferences