(Nov. 21, 2017) Medication adherence is essential to manage acute symptoms and reduce risk of relapse in adults with schizophrenia. In addition, it is well recognized that nonadherence is the most challenging aspect of treatment for these individuals. A key factor for individuals with schizophrenia to discontinue medications is a lack of insight into their disease, a condition known as anosognosia.
Data on adverse outcomes and costs are needed for effective public policy changes to improve medication adherence. Poor health outcomes, including increased risk of hospitalization and higher treatment costs, have been shown to increase with low medication adherence in some populations with mental illness, such as veterans and privately insured individuals. There is no comprehensive evidence that exists on the implications of medication adherence and costs for publically-insured individuals though. New research published in the November 2017 issue of Psychiatric Services examines the effects of medication adherence on risk of hospitalization and expenditures among Medicare enrollees with schizophrenia.
Associations with hospitalization and costs
Pamela Roberto and colleagues examined Medicare data on 13,681 individuals with schizophrenia obtained from the Centers for Medicare and Medicaid Services Chronic Conditions Warehouse for 2011 and 2012. Their objective was to test the association between adherence to antipsychotic therapy, psychiatric hospitalization and hospital expenditures among these individuals.
Adherence to antipsychotic medications significantly lowers risk for hospitalization among Medicare enrollees with schizophrenia, according to results from the study. Among the findings, individuals who took their medication more than 70% of the time had a 49% reduction in probability of hospitalization. In addition, medication adherence was associated with 53-65% lower costs, mainly due to reductions in psychiatric hospitalization.
This relationship was linear. Therefore, individuals with schizophrenia who more-greatly adhered to their medication had even lower risks of hospitalization and lower costs associated.
Anosognosia is a key issue of focus at the Treatment Advocacy Center. To learn more, read our background paper on the topic.
Elizabeth Sinclair
Research Associate
References:
- Roberto, P. et al. (November2017). Adherence to antipsychotic therapy:Association with hospitalization and Medicare spending among part D enrollees with schizophrenia. Psychiatric Services.
The Treatment Advocacy Center does not solicit or accept funds from pharmaceutical companies.