Document Detail


Incidence and costs of cardiometabolic conditions in patients with schizophrenia treated with antipsychotic medications.
MedLine Citation:
PMID:  20880826     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To examine the incidence of cardiometabolic conditions and change in care costs for patients with schizophrenia treated with antipsychotic medications, medical and pharmacy claims from the South Carolina Medicaid program were used to compare the incidence rates for five cardiometabolic conditions in 2,231 patients with schizophrenia who were newly prescribed one of seven antipsychotic medications, using a retrospective cohort design spanning three years. Incidence and cumulative prevalence (pre-existing + incident) rates for the five cardiometabolic conditions were: 10%/23.3% for Type II diabetes mellitus, 7%/13.3% for obesity/excessive weight gain, 17%/20.9% for dyslipidemia, 4.5%/7.3% for high blood pressure, and 15.6%/41.8% for hypertension. After being treated with the antipsychotic medications examined, the odds of developing obesity/excessive weight gain, Type II diabetes mellitus, or dyslipidemia were not significantly related to any specific atypical agent compared to haloperidol. Incidence rates for elevated blood pressure and clinically diagnosed hypertension were higher for patients prescribed ziprasidone (Odds Ratio [OR]=2.41, Confidence Intervals [CI]=1.20-4.85; OR=1.83, CI=1.16-2.90, respectively) relative to those prescribed haloperidol. Cost results indicate significant differences over time in medical service and pharmacy costs in the group which developed incident cardiometabolic conditions. Individuals diagnosed with schizophrenia with moderate prevalence and incidence rates for these cardiometabolic conditions demonstrated substantially decreasing medical care costs over the three years examined, perhaps indicating a widening gap in access to needed services for conditions that are known mortality risk factors.
Authors:
Jeanette M Jerrell; Roger S McIntyre; Avnish Tripathi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Clinical schizophrenia & related psychoses     Volume:  4     ISSN:  1935-1232     ISO Abbreviation:  Clin Schizophr Relat Psychoses     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2010-11-30     Revised Date:  2011-05-06    
Medline Journal Info:
Nlm Unique ID:  101312513     Medline TA:  Clin Schizophr Relat Psychoses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  161-8     Citation Subset:  IM    
Affiliation:
Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC 29203, USA. jeanette.jerrell@uscmed.sc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antipsychotic Agents / adverse effects,  economics,  therapeutic use*
Blood Pressure / drug effects
Cardiovascular Diseases / economics*,  epidemiology*
Cohort Studies
Comorbidity
Diabetes Mellitus, Type 2 / economics,  epidemiology
Dyslipidemias / economics,  epidemiology
Female
Health Care Costs / statistics & numerical data*
Humans
Hypertension / economics,  epidemiology
Incidence
Male
Metabolic Diseases / economics*,  epidemiology*
Middle Aged
Obesity / economics,  epidemiology
Odds Ratio
Prescription Fees / statistics & numerical data
Retrospective Studies
Risk Factors
Schizophrenia / drug therapy*,  epidemiology*
South Carolina / epidemiology
Young Adult
Chemical
Reg. No./Substance:
0/Antipsychotic Agents
Comments/Corrections
Comment In:
Clin Schizophr Relat Psychoses. 2011 Apr;5(1):54; author reply 54   [PMID:  21459740 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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