Cardiometabolic comorbidities and life expectancy in people on medication for schizophrenia in Australia

Abstract

Objective: This study aimed to assess the risks of people on medication for schizophrenia developing different components of the metabolic syndrome and their life expectancy, through reference to a representative population of Australians without schizophrenia.

Method: Pharmacy payment-claim records from the Pharmaceutical Benefits Scheme were analyzed based on a representative 10% sample of Medicare numbers supplied by the Department of Human Services. Records were analyzed based on the date of supply of the prescription and the dataset included year of death information. Two major analyses were conducted for 9,533 people on medication for schizophrenia and a 1:1 sex/age matched control, followed for up to 7 years. Patient life expectancy was estimated by performing a Kaplan Meier survival analysis.

Results: People on medication for schizophrenia compared to controls were 1.91-times (95% CI = 1.66–2.21) and 1.28-times (95% CI = 1.15–1.43) more likely to start treatment for diabetes and hyperlipidemia, respectively, but were no more likely to start treatment for hypertension (hazard ratio = 0.87; 95% CI = 0.78–0.97). Overall, people on medication for schizophrenia were 1.32-times more likely to start treatment for one of these three comorbidities. Median life expectancy was assessed as 80 years for people on medication for schizophrenia, and 91 years for controls.

Conclusions: The results for this study confirm in a large representative Australian sample of people on medication for schizophrenia, an excess risk of components of the metabolic syndrome and early death.

Keywords:

• Cardiovascular
• life expectancy
• metabolic
• schizophrenia

Transparency

Declaration of funding

Servier Australia provided the funding to source and analyze the data. The authors were responsible for the analysis and interpretation, independent of the funding source.

Declaration of financial/other relationships

D.J.C. has received grant monies for research from Eli Lilly, Janssen Cilag, Roche, Allergen, Bristol-Myers Squibb, Pfizer, H. Lundbeck, Astra Zeneca, Hospira; Travel Support and Honoraria for Talks and Consultancy from Eli Lilly, Bristol-Myers Squibb, Astra Zeneca, H. Lundbeck, Janssen Cilag, Pfizer, Organon, Sanofi-Aventis, Wyeth, Hospira, Servier; and is a current Advisory Board Member for Lu AA21004: H. Lundbeck; Varenicline: Pfizer; Asenapine: H. Lundbeck; Aripiprazole LAI: H. Lundbeck; Lisdexamfetamine: Shire; Lurasidone: Servier; Brexpiprazole: H. Lundbeck; Treatment Resistant Depression: LivaNova. E.C. has acted as a supplier and analyst of Medicare data to Servier over a range of projects, all of which were approved by the External Request Evaluation Committee of Medicare Australia. A reviewer on this manuscript has received research grants from H. Lundbeck and Otsuka Pharmaceuticals for clinical trials, received speaking fees from Bristol-Myers Squibb, Astra Zeneca, Janssen & Cilag, H. Lundbeck, Servier, Otsuka Pharmaceuticals, and Eli Lilly, and has acted as an advisor to Astra Zeneca, Eli Lilly, H. Lundbeck, Otsuka Pharmaceuticals, Takeda, and Medivir. Peer reviewers on this manuscript have received an honorarium from CMRO for their review work, but have no other relevant financial relationships to disclose.

Acknowledgments

Study conceptualization—Gary Hamann, Servier Australia and David Castle. The authors thank Kim Magner, Melbourne, VIC, Australia for providing medical writing support, which was funded by Servier Australia, Melbourne, VIC, Australia in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).