Báo cáo y học: "The cost of relapse and the predictors of relapse in the treatment of schizophrenia"

The cost of relapse and the predictors of relapse in the treatment of schizophrenia | Ascher-Svanum et al. BMC Psychiatry 2010 10 2 http 1471-244X 10 2 BMC Psychiatry RESEARCH ARTICLE Open Access The cost of relapse and the predictors of relapse in the treatment of schizophrenia Haya Ascher-Svanum1 Baojin Zhu2 Douglas E Faries2 David Salkever3 Eric P Slade4 5 Xiaomei Peng2 Robert R Conley6 Abstract Background To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. Methods Data were drawn from a prospective observational noninterventional study of schizophrenia in the United States US-SCAP conducted between 7 1997 and 9 2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed. Results Of 1 557 participants with eligible data 310 20 relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages poorer medication adherence more severe symptoms a higher prevalence of substance use disorder and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse above and beyond information about patients functioning and symptom levels. Conclusions Despite the historical decline in utilization of psychiatric inpatient services relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia. Background Schizophrenia is a .

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