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. 2024 Aug 27;50(5):1094-1103.
doi: 10.1093/schbul/sbad175.

The PSY-SIM Model: Using Real-World Data to Inform Health Care Policy for Individuals With Chronic Psychotic Disorders

Claire de Oliveira  1   2   3 , Joyce Mason  1 , Linda Luu  4 , Tomisin Iwajomo  1   2 , Frances Simbulan  5   4 , Paul Kurdyak  1   2   5   6 , Petros Pechlivanoglou  2   5   4
Affiliations

The PSY-SIM Model: Using Real-World Data to Inform Health Care Policy for Individuals With Chronic Psychotic Disorders

Claire de Oliveira et al. Schizophr Bull. .

Abstract

Background and hypothesis: Few microsimulation models have been developed for chronic psychotic disorders, severe and disabling mental disorders associated with poor medical and psychiatric outcomes, and high costs of care. The objective of this work was to develop a microsimulation model for individuals with chronic psychotic disorders and to use the model to examine the impact of a smoking cessation initiative on patient outcomes.

Study design: Using health records and survey data from Ontario, Canada, the PSY-SIM model was developed to simulate health and cost outcomes of individuals with chronic psychotic disorders. The model was then used to examine the impact of the Smoking Treatment for Ontario Patients (STOP) program from Ontario on the development of chronic conditions, life expectancy, quality of life, and lifetime health care costs.

Study results: Individuals with chronic psychotic disorders had a lifetime risk of 63% for congestive heart failure and roughly 50% for respiratory disease, cancer and diabetes, and a life expectancy of 76 years. The model suggests the STOP program can reduce morbidity and lead to survival and quality of life gains with modest increases in health care costs. At a long-term quit rate of 4.4%, the incremental cost-effectiveness ratio of the STOP program was $41,936/QALY compared with status quo.

Conclusions: Smoking cessation initiatives among individuals with chronic psychotic disorders can be cost-effective. These findings will be relevant for decision-makers and clinicians looking to improving health outcomes among this patient population.

Keywords: chronic psychotic disorders; microsimulation; psychosis; schizophrenia; smoking cessation.

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Figures

Fig. 1.
Fig. 1.
PSY-SIM model schematic. Note:‡ respiratory disease includes asthma and chronic obstructive pulmonary disease.
See this image and copyright information in PMC

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