The True Cost of Non-Adherence in Schizophrenia

Emsley, Robin
August 2010
Mind & Brain, The Journal of Psychiatry;Aug2010, Vol. 1 Issue 2, p1
Academic Journal
Non-adherence to prescribed antipsychotic drugs by schizophrenia patients is a major cause of treatment failure and poor functional outcomes, and increases the likelihood of psychiatric hospitalization, which in turn increases the overall cost of care. Non-adherence to therapy has also been associated with a greater propensity to violent acts, including suicide, substance abuse, and related behavior. Moreover, with persistence of symptoms, people with schizophrenia find it hard to remain employed and become increasingly socially excluded. It is particularly important to ensure adherence to therapy during the early phase of the disease process, as this may greatly impact long-term treatment outcomes. As treatment adherence is a complex phenomenon affected by interacting parameters, such as psychopathology, poor insight, medication-related factors, social support, comorbidities, associated substance abuse, and patient-physician relationship, a multifaceted approach to improving treatment compliance that includes both psychosocial and pharmacological therapeutic measures is required. Long-acting injectable (LAI) formulations of antipsychotic drugs have the potential to reduce non-adherence and consequently improve clinical outcomes. In particular, LAI risperidone, a second-generation antipsychotic agent, has yielded significant improvements in overall symptoms, quality of life and patient satisfaction, and reduced hospitalization, compared to oral antipsychotics, in patients with schizophrenia. When used in early psychosis, LAI risperidone has been associated with sustained remission in a majority of cases. Inadequate adherence to antipsychotic drugs compromises treatment outcomes in schizophrenia patients. LAI preparations of antipsychotic drugs have the potential to improve adherence to therapy and treatment outcomes in these patients.


Related Articles

  • Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States. Furiak, Nicolas M.; Ascher-Svanum, Haya; Klein, Robert W.; Smolen, Lee J.; Lawson, Anthony H.; Conley, Robert R.; Culler, Steven D. // Cost Effectiveness & Resource Allocation;2009, Vol. 7, Special section p1 

    Background: Schizophrenia is often a persistent and costly illness that requires continued treatment with antipsychotics. Differences among antipsychotics on efficacy, safety, tolerability, adherence, and cost have cost-effectiveness implications for treating schizophrenia. This study compares...

  • Strategies for increasing treatment compliance: The role of long-acting antipsychotics. Love, Raymond C. // American Journal of Health-System Pharmacy;11/15/2002 Supplement, Vol. 59, pS10 

    Increased patient compliance with antipsychotic medications is associated with increased efficacy and reduced rates of rehospitalization. It can improve treatment outcomes for patients and reduce costs for society. An understanding of the reasons for noncompliance is essential in formulating...

  • Cost of antipsychotic polypharmacy in the treatment of schizophrenia. Zhu, Baojin; Ascher-Svanum, Haya; Faries, Douglas E.; Correll, Christoph U.; Kane, John M. // BMC Psychiatry;2008, Vol. 8, Special section p1 

    Background: This study compared the costs of antipsychotic polypharmacy for patients who initiated on 1 of the 3 most commonly prescribed atypical antipsychotics -- olanzapine, quetiapine, or risperidone. Methods: Data were drawn from a large, prospective, naturalistic, multi-site, nonrandomized...

  • Financial cost of treating out-patients with schizophrenia in Nigeria. Suleiman, Toyin G.; Ohaeri, Jude U.; Lawal, Rahman A.; Haruna, Adam Y.; Orija, O. B.; Suleiman, T G; Ohaeri, J U; Lawal, R A; Haruna, A Y // British Journal of Psychiatry;Oct97, Vol. 171, p364 

    Background: An assessment of the monetary costs of treating a group of Nigerian out-patients with schizophrenia, in comparison with insulin-dependent diabetics, was made.Method: Fifty out-patients with schizophrenia (mean age 42.9) and 40 with diabetes (mean age 41.9),...

  • Compliance with treatment and its relevance for the management of schizophrenia. Hofer, Alex; Fleischhacker, W. Wolfgang // Hot Topics in Neurology & Psychiatry;Jun2011, Issue 11, p7 

    Poor compliance with treatments for schizophrenia limits their effectiveness and results in an increased risk of relapse, a greater likelihood of hospital admission, a longer duration of hospitalization, as well as antipsychotic treatment resistance and development of chronic psychosis. Although...

  • Psychiatrists' awareness of adherence to antipsychotic medication in patients with schizophrenia: results from a survey conducted across Europe, the Middle East, and Africa. Olivares, José Manuel; Alptekin, Köksal; Azorin, Jean-Michel; Cañas, Fernando; Dubois, Vincent; Emsley, Robin; Gorwood, Philip; Haddad, Peter M.; Naber, Dieter; Papageorgiou, George; Roca, Miquel; Thomas, Pierre; Martinez, Guadalupe; Schreiner, Andreas // Patient Preference & Adherence;2013, Vol. 7, p121 

    Background: Nonadherence is common among patients with schizophrenia, although the rates vary according to means of assessment and patient population. Failure to adhere to medication can have a major impact on the course of illness and treatment outcomes, including increasing the risk of relapse...

  • Psychiatrists' awareness of partial and nonadherence to antipsychotic medication in schizophrenia: results from an Asia-Pacific survey. Manuel Olivares, Jose; Thirunavukarasu, Manickam; Kulkarni, Jayashri; Hong Yan Zhang; Mingyuan Zhang; Fan Zhang // Neuropsychiatric Disease & Treatment;2013, Vol. 9, p1163 

    Background: Nonadherence is a well-known problem among schizophrenia patients, among whom relapse is fivefold more likely, adversely affecting health, employment, and social functioning. The Spanish Adherencia Terapéutica en la Esquizofrenia (ADHES) survey was developed to determine the scope...

  • Long-Acting Injectable Antipsychotics and the Management of Nonadherence. Weiden, Peter J.; Solari, Hugo; Shiyum Kim; Bishop, Jeffrey R. // Psychiatric Annals;May2011, Vol. 41 Issue 5, p271 

    The article discusses the role of long-acting injectable (LAI) antipsychotic medications and long-term medication adherence in maintenance treatment of schizophrenia. Adherence problems associated with oral formulations for long-term schizophrenia treatment are addressed. Ways in which LAIs...

  • Efectos de la olanzapina sobre la entrada sensorial auditiva en la esquizofrenia. Arango, Celso; Summerfelt, Ann; Buchanan, Robert W. // American Journal of Psychiatry - Edición Española;Feb2004, Vol. 7 Issue 2, p124 

    No abstract available.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics