The cost of relapse and the predictors of relapse in the treatment of schizophrenia

To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003....

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Published inBMC psychiatry Vol. 10; no. 1; p. 2
Main Authors Ascher-Svanum, Haya, Zhu, Baojin, Faries, Douglas E, Salkever, David, Slade, Eric P, Peng, Xiaomei, Conley, Robert R
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 07.01.2010
BioMed Central
BMC
Subjects
Adolescent
Adult
Age of Onset
Ambulatory Care - economics
Antipsychotic Agents - administration & dosage
Antipsychotic Agents - therapeutic use
Care and treatment
Diseases
Drug abuse
Drug Costs
Drug use
Female
Follow-Up Studies
Health Care Costs - statistics & numerical data
Hospitalization
Hospitalization - economics
Hospitals
Humans
Male
Medical care, Cost of
Medication Adherence
Mental disorders
Patient outcomes
Probability
Propensity Score
Prospective Studies
Psychiatry
Recurrence
Relapse
Research article
Schizophrenia
Schizophrenia - drug therapy
Schizophrenia - economics
Schizophrenia - epidemiology
Schizophrenic Psychology
Severity of Illness Index
Studies
Substance abuse treatment
Suicides & suicide attempts
United States - epidemiology
Veterans
United States
United States > US
Online AccessGet full text

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Abstract To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed. Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels. Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.
AbstractList Abstract Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Methods: Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed. Results: Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels. Conclusions: Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.
To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.BACKGROUNDTo assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed.METHODSData were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed.Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels.RESULTSOf 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels.Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.CONCLUSIONSDespite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.
Background To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Methods Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed. Results Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels. Conclusions Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.
To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed. Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels. Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.
To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed. Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels. Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.
ArticleNumber 2
Audience Academic
Author Slade, Eric P
Ascher-Svanum, Haya
Salkever, David
Zhu, Baojin
Conley, Robert R
Faries, Douglas E
Peng, Xiaomei
AuthorAffiliation 5 VA VISN 5 Mental Illness Research, Education, and Clinical Center, US Department of Veterans Affairs, 10 North Greene Street, Baltimore, MD 21201, USA
4 University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA
6 US Medical Division, Lilly USA, LLC, Lilly Corporate Center, Indianapolis, IN 46285, USA
2 US Statistics, Lilly USA, LLC, Lilly Corporate Center, Indianapolis, IN 46285, USA
1 US Outcomes Research, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA
3 Department of Public Policy, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
AuthorAffiliation_xml – name: 4 University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, USA
– name: 1 US Outcomes Research, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA
– name: 5 VA VISN 5 Mental Illness Research, Education, and Clinical Center, US Department of Veterans Affairs, 10 North Greene Street, Baltimore, MD 21201, USA
– name: 3 Department of Public Policy, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
– name: 6 US Medical Division, Lilly USA, LLC, Lilly Corporate Center, Indianapolis, IN 46285, USA
– name: 2 US Statistics, Lilly USA, LLC, Lilly Corporate Center, Indianapolis, IN 46285, USA
Author_xml – sequence: 1
  givenname: Haya
  surname: Ascher-Svanum
  fullname: Ascher-Svanum, Haya
– sequence: 2
  givenname: Baojin
  surname: Zhu
  fullname: Zhu, Baojin
– sequence: 3
  givenname: Douglas E
  surname: Faries
  fullname: Faries, Douglas E
– sequence: 4
  givenname: David
  surname: Salkever
  fullname: Salkever, David
– sequence: 5
  givenname: Eric P
  surname: Slade
  fullname: Slade, Eric P
– sequence: 6
  givenname: Xiaomei
  surname: Peng
  fullname: Peng, Xiaomei
– sequence: 7
  givenname: Robert R
  surname: Conley
  fullname: Conley, Robert R
BackLink https://www.ncbi.nlm.nih.gov/pubmed/20059765$$D View this record in MEDLINE/PubMed
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2010 Ascher-Svanum et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Snippet To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Data were drawn...
Background To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Methods...
To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Data were drawn...
Abstract Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United...
To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.BACKGROUNDTo assess...
BACKGROUND: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States....
Abstract Background To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United...
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StartPage 2
SubjectTerms Adolescent
Adult
Age of Onset
Ambulatory Care - economics
Antipsychotic Agents - administration & dosage
Antipsychotic Agents - therapeutic use
Care and treatment
Diseases
Drug abuse
Drug Costs
Drug use
Female
Follow-Up Studies
Health Care Costs - statistics & numerical data
Hospitalization
Hospitalization - economics
Hospitals
Humans
Male
Medical care, Cost of
Medication Adherence
Mental disorders
Patient outcomes
Probability
Propensity Score
Prospective Studies
Psychiatry
Recurrence
Relapse
Research article
Schizophrenia
Schizophrenia - drug therapy
Schizophrenia - economics
Schizophrenia - epidemiology
Schizophrenic Psychology
Severity of Illness Index
Studies
Substance abuse treatment
Suicides & suicide attempts
United States - epidemiology
Veterans
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Title The cost of relapse and the predictors of relapse in the treatment of schizophrenia
URI https://www.ncbi.nlm.nih.gov/pubmed/20059765
https://www.proquest.com/docview/902187473
https://www.proquest.com/docview/733802267
http://dx.doi.org/10.1186/1471-244X-10-2
https://pubmed.ncbi.nlm.nih.gov/PMC2817695
https://doaj.org/article/e1b58e413ebd4ba585c74b3de6a15931
Volume 10
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