Otsuka America Pharmaceutical, Inc., Princeton, NJ, USA.
Community Ment Health J. 2013 Dec;49(6):625-9. doi: 10.1007/s10597-013-9638-y. Epub 2013 Aug 10.
Nonadherence to antipsychotic medications is widespread and compromises the outcome of patients with schizophrenia. Using the MarketScan Medicare claims database, this study examined the impact of medication adherence on healthcare utilization among Medicare insured schizophrenia patients. The study population was separated into two cohorts defined by medication adherence, one with a medication possession ratio (MPR) ≥0.7 (high adherence) and the other with a MPR <0.7(low adherence). Of the 354 patients identified, 126 (36 %) had high adherence (mean ± SD MPR 0.94 ± 0.09) and 228 (64 %) had low adherence (MPR 0.24 ± 0.19). All cause hospitalizations (0.68 vs. 0.44; p = 0.015) and length of stay (LOS) (7.0 vs. 2.6 days; p = 0.005), and relapse hospitalizations (0.22 vs. 0.11; p = 0.028) and LOS (3.2 vs. 0.7 days; p = 0.027) were greater among patients with low adherence. Low adherent Medicare insured patients with schizophrenia require significantly more inpatient care and represent a patient population in which effective interventions are needed to improve disease management.
抗精神病药物治疗不依从的现象非常普遍，会影响精神分裂症患者的治疗结局。本研究利用 MarketScan Medicare 理赔数据库，考察了药物治疗依从性对医疗保险覆盖的精神分裂症患者医疗保健利用的影响。研究人群分为两组，根据药物治疗依从性定义，一组患者的药物使用剂量（MPR）≥0.7（高依从性），另一组患者的 MPR<0.7（低依从性）。在确定的 354 例患者中，126 例（36%）具有高依从性（平均 MPR±SD 为 0.94±0.09），228 例（64%）具有低依从性（MPR 0.24±0.19）。低依从性患者的全因住院率（0.68 比 0.44；p=0.015）和住院时间（LOS）（7.0 比 2.6 天；p=0.005），以及因复发住院率（0.22 比 0.11；p=0.028）和 LOS（3.2 比 0.7 天；p=0.027）均更高。需要注意的是，药物治疗依从性低的医疗保险覆盖的精神分裂症患者需要更多的住院治疗，这一患者群体需要有效的干预措施来改善疾病管理。
