Towards a framework for treatment effectiveness in schizophrenia

Figures & data

Table 1 Primary endpoints from large pragmatic studies

Trial	Primary endpoint	References
SOHO	CGI, quality of life, social functioning	Dossenbach et al^Citation17 Haro et al^Citation18
CUtLASS	Quality of life	Jones et al^Citation19 Lewis et al^Citation20
EUFEST	Loss of retention (time to discontinuation)	Kahn et al^Citation11
BETA	CGI improvement	Tandon et al^Citation21
CATIE	All cause discontinuation	Lieberman et al^Citation12 Stroup et al^Citation16
CAFE	All cause discontinuation	McEvoy et al^Citation22

Abbreviations: BETA, Broad Effectiveness Trial with Aripiprazole; CAFE, Comparison of Atypicals in First Episode Psychosis; CATIE, Clinical Antipsychotic Trials of Intervention Effectiveness; CGI, Clinical Global Impression; CUtLASS, Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study; EUFEST, European First Episode Schizophrenia Trial; SOHO, Schizophrenia Outpatient Health Outcome.

Table 2 Importance of the framework domains as voted for by 149 psychiatrists attending a large educational meeting

Domain	Essential (%)	Very important (%)	Desirable (%)	Irrelevant (%)
Symptomatic remission	28	51	19	2
Retention in treatment	40	46	11	3
Affective symptoms	16	73	9	2
Cognitive functioning	14	56	21	9
Treatment satisfaction	43	40	9	8
Personal and social functioning	43	40	14	3

Figure 1 The hypothesized interaction between effectiveness domains.

Figure 2 Recommended domains and scales that make up the framework to assess the effectiveness of antipsychotics in schizophrenia. For symptomatic remission, items in parentheses refer to the specific PANSS items

Table 3 Summary of proposed assessments to enhance the measurement of treatment effectiveness in patients with schizophrenia

Domain	Instrument	Number of items	Time required	Frequency of assessment
Symptomatic remission	PANSS	8 items	16 minutes	Monthly
Retention in treatment	–	–	–	Yearly
Affective symptoms	PANSS	2 items	4 minutes	Monthly
Cognitive functioning	BACS	6 tests	35 minutes	Yearly
Treatment satisfaction	MSQ	1 item	2 minutes	Monthly
Personal and social functioning	PSP	4 domains	10 minutes	Monthly

Abbreviations: BACS, Brief Assessment of Cognition in Schizophrenia; MSQ, Medication Satisfaction Questionnaire; PANSS, Positive and Negative Syndrome Scale; PSP, Personal and Social Performance.

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