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Am J Manag Care. 2020 Mar;26(3 Suppl):S62-S68. doi: 10.37765/ajmc.2020.43013.
Schizophrenia is a complicated chronic disease affecting approximately 3.5 million people in the United States, and its annual healthcare costs exceed $155 billion. People living with schizophrenia often experience a reduced quality of life (QOL) and are more likely to be homeless, unemployed, or living in poverty compared with the general population. Life expectancy for patients with schizophrenia is 15 to 20 years below the average and is complicated by numerous comorbidities, such as weight gain, increased cardiovascular risk, and changes in mood and cognition. Treatment nonadherence can increase the risk of relapse, rehospitalization, and self-harm, leading to a reduced QOL and increased economic burden. Managed care professionals are positioned to improve adherence and outcomes through various drug utilization strategies. Clinicians may also empower patients with schizophrenia through shared decision making and the creation of a therapeutic alliance. Careful monitoring of medication-related adverse effects and offering potential medication alternatives and routes of administration when indicated may also improve adherence to treatment regimens, resulting in improved outcomes and reduced healthcare costs.
精神分裂症是一种复杂的慢性疾病，影响了美国约 350 万人，其每年的医疗保健费用超过 1550 亿美元。与普通人群相比，精神分裂症患者的生活质量往往较低，更有可能无家可归、失业或生活贫困。精神分裂症患者的预期寿命比平均水平低 15 到 20 年，并且还存在多种合并症，如体重增加、心血管风险增加以及情绪和认知的变化。治疗不依从会增加复发、再次住院和自残的风险，导致生活质量下降和经济负担增加。管理式医疗保健专业人员可以通过各种药物利用策略来提高依从性和治疗效果。临床医生也可以通过共同决策和建立治疗联盟来赋予精神分裂症患者权力。当出现药物相关的不良反应时，仔细监测并提供潜在的药物替代方案和给药途径，也可以提高治疗方案的依从性，从而改善治疗效果并降低医疗保健费用。
