Abstract
In this year-long, prospective observational study, sociodemographic, clinical, and functional characteristics were assessed in outpatients with schizophrenia from Australia, Mexico, Romania, and Taiwan who were switched from their primary oral antipsychotic to another oral or depot antipsychotic at study entry because of physician-perceived nonadherence risks. Patients (N = 406) rated their quality of life and functioning level as low. Few patients (10.6%, 43/406) were switched to depot antipsychotics, with country-specific differences (P < 0.001). Although illness severity was similar between subgroups, the depot switch subgroup had: a documented history of nonadherence (32.6% versus oral: 4.7%); recent alcohol (48.8% versus 23.2%; P < 0.001) or illicit drug use (16.3% versus 5.0%; P = 0.010); recent depot antipsychotic (20.7% versus 7.5%; P = 0.030) and mood stabilizer use (51.7% versus 26.3%; P = 0.008); poorer attitudes towards medication (P = 0.004); and poorer illness awareness (P = 0.041). Findings indicate that even when a risk of nonadherence has been identified, few patients with schizophrenia receive depot antipsychotics, despite being prime candidates for depot therapy. Findings suggest physicians may select depot therapy based on previous nonadherence, substance use, recent depot antipsychotic and mood stabilizer use, poor attitudes towards medications, and poor illness awareness.
Acknowledgements
This study was sponsored by Eli Lilly and Company. Eli Lilly was involved in the study design, data collection, data analysis, and preparation of the manuscript. In compliance with the Uniform Requirements for Manuscripts, established by the International Committee of Medical Journal Editors, the sponsor of this study did not impose any impediment, directly or indirectly, on the publication of the study’s results.
The authors acknowledge statistical analysis assistance provided by George Zhao. The authors also acknowledge the independent medical writing assistance provided by ProScribe Medical Communications (www.proscribe.com.au), funded from an unrestricted financial grant from Eli Lilly Australia. ProScribe’s services complied with international guidelines for Good Publication Practice.
Contributors
All authors participated in the interpretation of study results, and critically revised draft versions and approved the final version of the manuscript. AJM Brnabic, K Kelin, and W Montgomery participated in the design and conduct of the study. LJ Chuo, RI Escamilla, R Newton, and M Simu were investigators in the study. LJ Chuo, RI Escamilla, R Newton, and W Ye participated in data collection. AJM Brnabic and W Ye participated in the statistical analyses.
Disclosure
K Kelin, AJM Brnabic, J Karagianis, W Montgomery, W Ye, and H Ascher-Svanum are employees of Eli Lilly and Company. R Newton has received honoraria from Astra-Zeneca, Eli Lilly and Company, Janssen-Cilag Pty Limited, and Lundbeck Australia Pty Ltd. AJM Brnabic, J Karagianis, W Montgomery, and W Ye are shareholders in Eli Lilly and Company. LJ Chuo, RI Escamilla, and M Simu report no conflicts of interest in this work.