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. 2008 Feb 2:2:67-77.
doi: 10.2147/ppa.s2940.

Adherence and persistence to typical and atypical antipsychotics in the naturalistic treatment of patients with schizophrenia

Haya Ascher-Svanum  1 , Baojin Zhu, Douglas E Faries, Jonathan P Lacro, Christian R Dolder, Xiaomei Peng
Affiliations

Adherence and persistence to typical and atypical antipsychotics in the naturalistic treatment of patients with schizophrenia

Haya Ascher-Svanum et al. Patient Prefer Adherence. .

Abstract

Objective: To compare adherence and persistence to typical versus atypical antipsychotics and between specific atypical agents in the usual care of schizophrenia and to examine the association between adherence and persistence.

Method: Data were drawn from a 3-year prospective, nonrandomized, noninterventional study of schizophrenia conducted during 1997-2003. Initiators on haloperidol, risperidone, olanzapine, quetiapine, and clozapine with at least 1 year of follow-up were included (n = 878). Adherence (Medication Possession Ratio, MPR) and persistence (time to all-cause medication discontinuation) were assessed using medical record prescription information. Analyses employed multivariate statistics adjusted for group differences.

Results: Overall, 58% of the patients were deemed adherent (MPR >80%). Adherence rates were higher: for atypical (59.4%) than typical antipsychotics (34.5%, p < 0.001), for clozapine (77%) than each comparator excluding olanzapine (p < 0.01), and for olanzapine (64%) than risperidone (57%, p = 0.027) and quetiapine (52%, p = 0.019). Differences between risperidone and quetiapine were not statistically significant. Adherence and persistence were highly correlated (r = 0.957, p < 0.001).

Conclusion: In the usual care of schizophrenia, medication adherence and persistence appear to be highly correlated and to significantly differ between typical and atypical antipsychotics and among atypical agents. The choice of antipsychotic may play a meaningful role in patients' adherence to and persistence with antipsychotic medications.

Keywords: adherence; antipsychotics; persistence; schizophrenia.

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References

    1. Al-Zakwani IS, Barron JJ, Bullano MF, et al. Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications. Curr Med Res Opin. 2003;19:619–26. - PubMed
    1. Ascher-Svanum H, Zhu B, Faries D, et al. A comparison of olanzapine and risperidone on the risk of psychiatric hospitalization in the naturalistic treatment of patients with schizophrenia. Ann Gen Hosp Psychiatry. 2004;3:11. - PMC - PubMed
    1. Ascher-Svanum H, Faries DE, Zhu B, et al. Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry. 2006a;67:453–60. - PubMed
    1. Ascher-Svanum H, Zhu B, Faries D, et al. Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia. BMC Psychiatry. 2006b;6:8. - PMC - PubMed
    1. Bagnall AM, Jones L, Ginnelly L, et al. A systematic review of atypical antipsychotic drugs in schizophrenia. Health Technol Assess. 2003;7:1–193. URL: http://www.ncchta.org/project.asp?PjtId=1235. Health Technology Assessment (HTA) on behalf of the National Institute for Clinical Excellence (NICE) in the UK. - PubMed