Atypical Treatment Switches in Schizophrenia Patients: Drivers and Associated Outcomes

Rezaul Khandker; Jason Shepherd; Farid Chekani; Zaina Qureshi; Hollie Bailey; Mia Berry; Jack Wright; Lucy Massey

doi:10.2147/NDT.S358392

Atypical Treatment Switches in Schizophrenia Patients: Drivers and Associated Outcomes

Neuropsychiatr Dis Treat. 2022 May 18:18:1057-1067. doi: 10.2147/NDT.S358392. eCollection 2022.

Authors

Rezaul Khandker¹, Jason Shepherd², Farid Chekani¹, Zaina Qureshi¹, Hollie Bailey², Mia Berry², Jack Wright², Lucy Massey²

Affiliations

¹ Merck & Co., Inc., Kenilworth, NJ, USA.
² Adelphi Real World, Bollington, UK.

Abstract

Objective: To describe and compare demographics and outcomes among patients with schizophrenia who have switched atypical treatments versus non-switchers.

Methods: Data were extracted from the Adelphi Schizophrenia Disease Specific Programme™ conducted from January to May 2014 in the United States. Participating physicians provided information on their next 10 consulting schizophrenia patients aged ≥ 18 years; the same patients were invited to voluntarily complete a patient self-completion form (PSC). Patients were considered switchers (S) or non-switchers (NS) based on their physician-provided treatment history. S were patients who had switched, stopped or added an atypical treatment within the last 2 years. NS had no treatment changes within the last 2 years or were receiving their first-line treatment (for ≥ 3 months). Demographics, clinical characteristics and outcomes among S and NS were compared using both descriptive and multivariate statistics.

Results: One-hundred fifty physicians provided data on 1003 patients with schizophrenia (395 S, 608 NS); 500 patients completed a PSC (170 S, 330 NS). When compared with NS, S were more likely to be unemployed (p=0.0060), have a caregiver (p<0.0001), have greater activity impairment as assessed by Work and Productivity Activity Impairment (p=0.0031), be hospitalized for schizophrenia (p<0.0001) and have had a greater mean number of hospitalizations in the last 12 months (p=0.0012). NS vs S were more likely to have much or very much improved illness (p<0.0001) and less severe disease (p<0.0001) as assessed by Clinical Global Impression.

Conclusion: Despite switching drugs, some schizophrenia patients continue to have high levels of disease burden, suggesting that currently available therapies are insufficiently effective in these patients.

Keywords: CGI; EQ-5D; WPAI; atypical treatment; compliance; outcomes; quality of life; schizophrenia; switching.

Grants and funding

Data collection was undertaken by Adelphi Real World as part of an independent survey, entitled the Adelphi Schizophrenia Disease Specific Programme, sponsored by multiple pharmaceutical companies of which one was Merck Sharp & Dohme Corp. Merck Sharp & Dohme Corp. did not influence the original survey through either contribution to the design of questionnaires or data collection. The study described here using data from the Adelphi Schizophrenia Disease Specific Programme was funded by Merck Sharp & Dohme Corp.