PATIENTS' EARLY PERCEPTIONS OF MEDICATIONS' BENEFITS PREDICT SUBSEQUENT RESPONSE IN THE TREATMENT OF SCHIZOPHRENIA
Author(s)
Nyhuis A1, Ascher-Svanum H1, Faries D1, Stauffer VL2, Kollack-Walker S2, Kinon BJ1, Weiden PJ31Eli Lilly and Company, Indianapolis, IN, USA, 2Lilly USA, LLC, Indianapolis, IN, USA, 3University of Illinois at Chicago, Chicago, IL, USA
OBJECTIVES: To assess whether a brief and simple assessment of patients’ early perceptions of medications’ benefits can predict subsequent response or non-response to continued treatment with the same antipsychotic medication. METHODS: This post-hoc analysis used data from a cost-effectiveness study of antipsychotics in the treatment of schizophrenia (HGGD) in which the Rating of Medication Influences scale (ROMI) was assessed following 2 weeks of treatment. Patients rated ROMI items on a scale from 1 (no agreement) to 3 (strong agreement). Patients’ scores on the ROMI’s “Perceived Medication Benefits,” a 4-item subscale identified in prior research, were used to predict subsequent response to continued treatment with the medication at Week 8. Response was defined as at least 20% reduction on the Positive and Negative Syndrome Scale (PANSS) total score from baseline to Week 8. Logistic regression was used to assess whether the ROMI “Perceived Medication Benefits” score was a strong predictor of subsequent response and identify the best cut-off score for the prediction model. Analysis was conducted on 439 patients who had PANSS and ROMI data at the 2-week and 8-week time points. RESULTS: A score of 2.75 or higher on the Perceived Medication Benefits subscale at Week 2 predicted subsequent response (per PANSS) at Week 8 with high specificity (72%) and negative predictive value (70%), moderate sensitivity (44%) and positive predictive value (47%) and with a 38% misclassification rate. CONCLUSIONS: A brief assessment of patients’ early perceptions of medications’ benefits (at Week 2) appears to be a good predictor of subsequent response/non-response to continued treatment with the same medication. Predictive values appear comparable to those reported in prior studies in which early response was assessed with a clinician-rated symptom scale, which requires special training and repeated assessments. Further research is needed to replicate the current findings.
Conference/Value in Health Info
2010-05, ISPOR 2010, Atlanta, GA, USA
Value in Health, Vol. 13, No. 3 (May 2010)
Code
PMH9
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Mental Health