Assessing Antipsychotic Adherence in People With Cognitive Impairment Associated With Schizophrenia: A US Non-Interventional Cohort Study of Real-World Data
Author(s)
Rashmi Patel, MD, PhD1, Ling Zhang, MD, MS, MPH2, Theresa Cassidy, MPH2, Patrick Keeler, PhD3, Sebastien Tulliez, MBA3;
1University of Cambridge, Department of Psychiatry, Cambridge, United Kingdom, 2Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA, 3Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
1University of Cambridge, Department of Psychiatry, Cambridge, United Kingdom, 2Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA, 3Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
Presentation Documents
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)