Neuropsychiatric Disease and Treatment (May 2022)

Atypical Treatment Switches in Schizophrenia Patients: Drivers and Associated Outcomes

  • Khandker R,
  • Shepherd J,
  • Chekani F,
  • Qureshi Z,
  • Bailey H,
  • Berry M,
  • Wright J,
  • Massey L

Journal volume & issue
Vol. Volume 18
pp. 1057 – 1067

Abstract

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Rezaul Khandker,1 Jason Shepherd,2 Farid Chekani,1 Zaina Qureshi,1 Hollie Bailey,2 Mia Berry,2 Jack Wright,2 Lucy Massey2 1Merck & Co., Inc., Kenilworth, NJ, USA; 2Adelphi Real World, Bollington, UKCorrespondence: Farid Chekani, Merck & Co., Inc., Kenilworth, NJ, USA, Tel +1-267-305-4070, Email [email protected]: To describe and compare demographics and outcomes among patients with schizophrenia who have switched atypical treatments versus non-switchers.Methods: Data were extracted from the Adelphi Schizophrenia Disease Specific Programme™ conducted from January to May 2014 in the United States. Participating physicians provided information on their next 10 consulting schizophrenia patients aged ≥ 18 years; the same patients were invited to voluntarily complete a patient self-completion form (PSC). Patients were considered switchers (S) or non-switchers (NS) based on their physician-provided treatment history. S were patients who had switched, stopped or added an atypical treatment within the last 2 years. NS had no treatment changes within the last 2 years or were receiving their first-line treatment (for ≥ 3 months). Demographics, clinical characteristics and outcomes among S and NS were compared using both descriptive and multivariate statistics.Results: One-hundred fifty physicians provided data on 1003 patients with schizophrenia (395 S, 608 NS); 500 patients completed a PSC (170 S, 330 NS). When compared with NS, S were more likely to be unemployed (p=0.0060), have a caregiver (p< 0.0001), have greater activity impairment as assessed by Work and Productivity Activity Impairment (p=0.0031), be hospitalized for schizophrenia (p< 0.0001) and have had a greater mean number of hospitalizations in the last 12 months (p=0.0012). NS vs S were more likely to have much or very much improved illness (p< 0.0001) and less severe disease (p< 0.0001) as assessed by Clinical Global Impression.Conclusion: Despite switching drugs, some schizophrenia patients continue to have high levels of disease burden, suggesting that currently available therapies are insufficiently effective in these patients.Keywords: schizophrenia, atypical treatment, switching, compliance, outcomes, quality of life, EQ-5D, WPAI, CGI

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