Guideline-Concordant Tx Cuts Mortality in Schizophrenia

Mortality also decreased with use of anti-Parkinson's medications, mental health visits

WEDNESDAY, Nov. 7 (HealthDay News) -- For patients with schizophrenia, adherence to antipsychotic medications, as recommended by the 2009 Schizophrenia Patient Outcomes Research Team (PORT), correlates with reduced mortality, according to research published online Oct. 30 in the Schizophrenia Bulletin.

Bernadette A. Cullen, M.B., B.Ch., of the Johns Hopkins School of Medicine in Baltimore, and colleagues conducted a retrospective, 10-year, cohort study to evaluate antipsychotic use in 2,132 adult Medicaid beneficiaries with schizophrenia and to determine whether adherence to guideline recommendations is associated with decreased mortality in this patient population.

The researchers found that annual antipsychotic continuity correlated with reduced mortality. Patients who had an annual continuity with their antipsychotic medication of 90 percent or higher versus those with annual medication possession rates of less than 10 percent had a significantly lower hazard ratio for mortality (0.75). Patients using first-generation antipsychotic medications equal to or greater than 1,500 chlorpromazine dosing equivalents had an increased risk of death (hazard ratio [HR], 1.88), while use of anti-Parkinson medications correlated with a significantly lower risk of death (HR, 0.72). Mental health visits also correlated with slightly, but significantly, lower mortality risk (HR, 0.96).

"Given this association between guideline adherence and reduced risk of mortality, further research should address why long-term adherence to PORT pharmacological guidelines is low among Medicaid beneficiaries with schizophrenia," the authors write. "In order to improve adherence to PORT guidelines, quality improvement programs should consider implementation of systems to routinely monitor outcomes among patients with schizophrenia."

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