@article{19ca7783271040c7b84ec7c1b783c17b,
title = "The cost of relapse and the predictors of relapse in the treatment of schizophrenia",
abstract = "Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.Methods: Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed.Results: Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels.Conclusions: Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.",
author = "Haya Ascher-Svanum and Baojin Zhu and Faries, {Douglas E.} and David Salkever and Slade, {Eric P.} and Xiaomei Peng and Conley, {Robert R.}",
note = "Funding Information: The US-SCAP study and its report were supported by Eli Lilly and Company, Indianapolis, IN, USA and administered by the Medstat Group. We wish to thank the site investigators and others who collaborated in the US-SCAP study: Barrio C, Ph.D., Center for Research on Child and Adolescent Mental Health Services, San Diego, CA; Dunn LA, M.D., Duke University Medical Center Department of Psychiatry, Durham, NC; Gal-lucci G, M.D., (previously) Johns Hopkins Bayview Medical Center and the University of Maryland Medical Systems, Baltimore, MD; Garcia P, Ph.D., Center for Research on Child and Adolescent Mental Health Services, San Diego, CA; Harding C, Ph.D., Boston University and Community Mental Health Centers in Denver, CO; Hoff R, Ph.D., M.P.H., West Haven Veterans Administration Medical Center (VAMC) and the Connecticut Mental Health Center (CMHC), West Haven, CT; Hough R, Ph.D., Center for Research on Child and Adolescent Mental Health Services, California, San Diego, CA; Lehman AF, M.D., Johns Hopkins Bayview Medical Center and the University of Maryland Medical Systems, Baltimore, MD; Palmer L, Ph.D., The Medstat Group, Inc., Washington, DC; Rosenheck RA, M.D., West Haven Veterans Administration Medical Center (VAMC) and the Connecticut Mental Health Center (CMHC), West Haven, CT; Russo P, Ph.D., M.S.W., R. N., (previously) The Medstat Group, Inc., Washington, DC; Salkever D, Ph.D., (previously) Johns Hopkins University, Department of Health Policy and Management, Baltimore, MD; Saunders T, M.S., Drug Abuse and Mental Health Program Office of District 7 and University of South Florida{\textquoteright}s Florida Mental Health Institute, Orlando, FL; Shern D, Ph.D., (previously) Drug Abuse and Mental Health Program Office of District 7 and University of South Florida{\textquoteright}s Florida Mental Health Institute, Orlando, FL; Shumway M, Ph.D., University of California at San Francisco, Department of Psychiatry, San Francisco, CA; Slade E, Ph.D., (previously) Johns Hopkins University, Department of Health Policy and Management, Baltimore, MD; Swanson J, Ph.D., Duke University Medical Center Department of Psychiatry, Durham, NC; Swartz M, M.D., Duke University Medical Center, Department of Psychiatry, Durham, NC. Funding Information: Dr. Ascher-Svanum is a full-time employee of Eli Lilly and Company. Drs. Zhu, Faries, Peng, and Conley are full-time employees of Lilly USA, LLC. All are shareholders in the study sponsor, Eli Lilly and Company. Dr. Salkever has served as a paid consultant to Eli Lilly and was an investigator on the US Schizophrenia Care and Assessment Program (US-SCAP). Dr. Slade served as a paid consultant to Eli Lilly on the US-SCAP, and his current work is supported in part by the US Department of Veterans Affairs, Capitol Network VISN5 Mental Illness Research and Education Clinical Center.",
year = "2010",
month = jan,
day = "7",
doi = "10.1186/1471-244X-10-2",
language = "English (US)",
volume = "10",
journal = "BMC psychiatry",
issn = "1471-244X",
publisher = "BioMed Central",
}