A Real-World Assessment of Outcomes in Schizophrenia Patients According to Treatment Response.

OBJECTIVE: To describe and compare demographics, outcomes, and comorbidities among schizophrenia patients according to treatment response. METHODS: A cross-sectional survey was conducted in the United States through the Adelphi Schizophrenia Disease Specific Program from January to May 2014. Participating physicians provided information on the first 10 schizophrenia patients aged ≥ 18 years they saw in daily clinical practice; these patients were invited to voluntarily complete a patient self-completion form. Patients were considered partial responders or responders based on the physician-reported Clinical Global Impressions improvement scale. Regression analyses were performed to identify potential drivers of response and the clinical and humanistic outcomes associated with response. RESULTS: 150 physicians provided data on 433 partial responders and 872 responders; 185 partial responders and 415 responders completed a patient self-completion form. A significant predictor of response was always being adherent with the medication regimen (P < .001). Positive symptoms (P = .006) and moderate (P = .004) or severe (P = .002) illness severity were significant predictors of inadequate response. Responders were more likely to have better EQ-5D (EuroQol 5 Dimensions) visual analog scale, Quality of Life Enjoyment and Satisfaction Questionnaire, and work productivity and impairment scores (all P < .05). CONCLUSIONS: Partial responders were more likely to have significantly poorer clinical and quality of life outcomes compared with responders. Improved therapeutic approaches, either new therapies or optimized treatments, could lead to both better outcomes and improved adherence in this population.

Assessment of Real-Life Outcomes in Schizophrenia Patients according to Compliance.

OBJECTIVE: To describe and compare demographics, outcomes and comorbidities in schizophrenia patients by treatment compliance. METHODS: This was a cross-sectional survey of hospital- or office-based psychiatrists who saw ≥6 schizophrenia patients per week and were responsible for treatment decisions. Recruited physicians completed a patient record form (PRF) for their first 10 consulted schizophrenia patients aged ≥18. These patients voluntarily completed a patient self-completion form (PSC). Compliance was measured by subjective physician assessment. Drivers of and outcomes associated with compliance were identified by regression analyses. RESULTS: A total of 150 physicians completed PRFs for 1489 patients (706 sometimes compliant (SC), 636 always compliant (AC)). A total of 680 patients completed a PSC (327 SC, 295 AC). AC patients were less likely to be male (52.2% vs. 58.6%; P = 0.021) and unemployed (odds ratio (OR) 0.91, 95% confidence interval (CI) 0.82-1.00; P < 0.001) or to have had a treatment regimen change (OR 0.56, 95% CI 0.40-0.80; P = 0.001) than SC patients. AC patients were less likely to have had more comorbidities (OR 0.91, 95% CI 0.82-1.00; P = 0.045) and hospitalizations in the past 12 months (OR 0.59, 95% CI 0.43-0.80; P = 0.001) than SC patients. Overall, AC patients had better clinical and humanistic outcomes. Weight gain was a common side effect for all patients; SC patients with weight gain had poorer outcomes than those without weight gain. CONCLUSION: Schizophrenia patients that were SC experienced poorer clinical outcomes and quality of life. Weight gain may exacerbate these poorer outcomes.