Assessing Antipsychotic Adherence in People With Cognitive Impairment Associated With Schizophrenia: A US Non-Interventional Cohort Study of Real-World Data
Moderator
Rashmi Patel, PhD, MD, University of Cambridge, Cambridge, United Kingdom
Speakers
Ling Zhang; Theresa Cassidy; Patrick Keeler; Sebastien Tulliez, MBA, MSc
OBJECTIVES: This non-interventional, retrospective study utilized de-identified real-world data (Optum Market Clarity database) to assess adherence to antipsychotics in patients with schizophrenia, with or without cognitive impairment associated with schizophrenia (CIAS).
METHODS: Eligible US adults had ≥2 schizophrenia diagnosis claims (October 1, 2016-March 31, 2022) and ≥1 year of continuous enrollment pre-index date (first schizophrenia diagnosis). CIAS status was determined using the pre-defined sum score method: >0, CIAS present (CIAS-Y), ≤0, CIAS not present (CIAS-N). Antipsychotic prescription data were analyzed from index date to end of follow-up (date of death, last encounter or end of database) and grouped into 4 categories: first-generation antipsychotic (FGA) oral and long-acting injection (LAI), second-generation antipsychotic (SGA) oral and LAI. The proportion of patients using antipsychotics, continuous use duration and category switch were measured overall and stratified by CIAS status.
RESULTS: Of 183,483 adults with schizophrenia assessed, 44,236 (24.1%) and 139,247 (75.9%) were categorized as CIAS-Y and CIAS-N, respectively (mean [standard deviation; SD] age: 52.2 [16.7] and 46.5 [15.9] years). Overall, 134,788 (73.5%) patients used antipsychotics (SGA oral: 87.1%, FGA oral: 37.7%, SGA LAI: 21.9%, FGA LAI: 10.3%), including 81.0% and 71.1% of CIAS-Y and CIAS-N patients, respectively. The most common first-line generic antipsychotics were oral: risperidone (17.8%, 18.6%), olanzapine (17.1%, 17.2%) and other (16.6%, 16.9%). Oral haloperidol was more commonly used by CIAS-Y patients (15.4% versus 10.3%). No difference was observed for LAI antipsychotics. CIAS-Y patients demonstrated shorter antipsychotic treatment durations versus CIAS-N patients (mean [SD] days: 206.5 [346.7], 239.7 [381.7]) and greater treatment switching frequency (25.1%, 15.6%).
CONCLUSIONS: While CIAS prevalence was low, patients with versus without CIAS demonstrated greater antipsychotic use, shorter continuous treatment durations and a greater tendency to switch between antipsychotic categories, suggesting a CIAS-related treatment burden and unmet need for effective treatment strategies.
FUNDING: Boehringer Ingelheim (1346-0085).
METHODS: Eligible US adults had ≥2 schizophrenia diagnosis claims (October 1, 2016-March 31, 2022) and ≥1 year of continuous enrollment pre-index date (first schizophrenia diagnosis). CIAS status was determined using the pre-defined sum score method: >0, CIAS present (CIAS-Y), ≤0, CIAS not present (CIAS-N). Antipsychotic prescription data were analyzed from index date to end of follow-up (date of death, last encounter or end of database) and grouped into 4 categories: first-generation antipsychotic (FGA) oral and long-acting injection (LAI), second-generation antipsychotic (SGA) oral and LAI. The proportion of patients using antipsychotics, continuous use duration and category switch were measured overall and stratified by CIAS status.
RESULTS: Of 183,483 adults with schizophrenia assessed, 44,236 (24.1%) and 139,247 (75.9%) were categorized as CIAS-Y and CIAS-N, respectively (mean [standard deviation; SD] age: 52.2 [16.7] and 46.5 [15.9] years). Overall, 134,788 (73.5%) patients used antipsychotics (SGA oral: 87.1%, FGA oral: 37.7%, SGA LAI: 21.9%, FGA LAI: 10.3%), including 81.0% and 71.1% of CIAS-Y and CIAS-N patients, respectively. The most common first-line generic antipsychotics were oral: risperidone (17.8%, 18.6%), olanzapine (17.1%, 17.2%) and other (16.6%, 16.9%). Oral haloperidol was more commonly used by CIAS-Y patients (15.4% versus 10.3%). No difference was observed for LAI antipsychotics. CIAS-Y patients demonstrated shorter antipsychotic treatment durations versus CIAS-N patients (mean [SD] days: 206.5 [346.7], 239.7 [381.7]) and greater treatment switching frequency (25.1%, 15.6%).
CONCLUSIONS: While CIAS prevalence was low, patients with versus without CIAS demonstrated greater antipsychotic use, shorter continuous treatment durations and a greater tendency to switch between antipsychotic categories, suggesting a CIAS-related treatment burden and unmet need for effective treatment strategies.
FUNDING: Boehringer Ingelheim (1346-0085).
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD61
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Mental Health (including addition)