Clinical and cost implications of treating schizophrenia: safety, efficacy, relapse prevention, and patient outcomes.

Clinical and cost implications of treating schizophrenia: safety, efficacy, relapse prevention, and patient outcomes.

J Clin Psychiatry. 2014 Aug;75(8):e20

Authors: Kane JM, Correll CU, Harvey PD, Olfson M

Abstract
Today, clinicians have an array of antipsychotic medications to choose from in treating patients with schizophrenia, as well as a range of programs and services designed to improve cognition and real-world functioning. Yet, perhaps only a third of patients can successfully live in the community long-term and remain in remission. Treatment failure or a relapse after what appeared to be significant improvement in a patient's psychotic symptoms and functioning also affects families, employers, payers, policy makers, and huge swathes of the health care system. In short, shortcomings in the treatment of schizophrenia have a significant impact on society as a whole, an impact that can be measured not only in terms of health and well-being but in dollars and cents. Studies evaluating the efficacy and cost-efficacy of antipsychotic medications and other forms of intervention are abundant, but it is uncertain how much of this valuable information reaches the average clinician and can then be applied in daily interactions with patients. This InfoPack aims to synthesize some of the important findings on new antipsychotics by explaining how to use the data from head-to-head comparisons and meta-analyses to evaluate different agents and choose the best one for the patient. It also reviews the evidence on cognitive remediation and antipsychotics in improving cognition and functional capacity. In particular, several short-term and long-term studies of the atypical antipsychotic lurasidone are discussed, including findings associated with cognition and improved functional capacity, the side effect profile, relapse prevention, and the cost savings that may be achieved by reducing the direct costs of care through an evidence-based selection of medication.

PMID: 25191911 [PubMed - as supplied by publisher]