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Effects of medication adherence on hospitalizations and healthcare costs in patients with schizophrenia in Thailand

Dilokthornsakul P 1 , Thoopputra T 2 , Patanaprateep O 3 , Kongsakon R 4 , Chaiyakunapruk N 5

Affiliations 

  • 1 Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
  • 2 Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
  • 3 Department of Health Informatics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 4 Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 5 Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia; School of Population Health, University of Queensland, Brisbane, QLD, Australia; School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
SAGE Open Med, 2016;4:2050312116637026.
PMID: 27026801 DOI: 10.1177/2050312116637026

Abstract

BACKGROUND: This study was conducted to determine the impacts of medication adherence on hospitalization and direct healthcare cost in patients with schizophrenia in Thailand.
METHODS: A retrospective study was undertaken. Patients with schizophrenia aged 18-65 years who visited a University hospital and received antipsychotics from April 2011 to October 2011 were included. Propensity score-adjusted logistic regression was used to determine the impacts of medication adherence on schizophrenia-related and all-cause hospitalizations.
RESULTS: A total of 582 patients were included. Three out of 224 patients (1.3%) were hospitalized with schizophrenia in optimal adherence group, while 10 of 140 (7.1%) were hospitalized in under-adherence group, and 7 of 218 (3.2%) were hospitalized in over-adherence group. Based on propensity score-adjusted multivariate logistic regression, the adjusted odds ratio was 5.86 (95% confidence interval = 1.53-22.50) for schizophrenia-related hospitalization and 8.04 (95% confidence interval = 2.20-29.40) for all-cause hospitalization. The average annual direct healthcare costs in patients with optimal adherence, under-adherence, and over-adherence were US$371 ± US$836, US$386 ± US$734, and US$508 ± US$2168, respectively.
CONCLUSION: An initiation of interventions to maintain optimal adherence in patients with schizophrenia would significantly impact the healthcare system.
KEYWORDS: Adherence; antipsychotics; cost; hospitalization

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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