Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications

Ibrahim S. Al-Zakwani, John J. Barron, Michael F. Bullano, Steve Arcona, Christopher J. Drury, Tara R. Cockerham

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: To examine the effects of typical and atypical antipsychotics on medication adherence and healthcare resource utilization. Research design and methods: This was a retrospective observational cohort analysis of pharmacy and medical health insurance reimbursement data of patients from a southeastern United States health plan. Pharmacy data of subjects between 6 and 65 years of age were identified. Inclusion criteria included initiation of a single antipsychotic agent between July 1, 1999 and September 30, 2000; no antipsychotic medication usage 6 months prior to the index prescription date; and continuous health plan enrollment for the 18-month study period. Multivariable methods were utilized to analyze healthcare resource utilizations between groups. Outcome measures: Primary outcome measures included: (1) adherence and persistence with antipsychotic therapy; (2) healthcare utilization for outpatient office and hospital visits, inpatient hospital visits, and emergency room visits; and (3) therapy modifications and concomitant medications. Results: A total of 469 patients met initial study criteria. Atypical and typical antipsychotics were prescribed to 384 and 85 patients, respectively. Length of therapy (days) for the atypical cohort was significantly longer (136 vs 80; p <0.001). As defined using medication possession ratio (MPR), the atypical cohort was significantly more adherent to therapy than the typical cohort (mean MPR, 0.53 vs 0.24; p <0.001). After adjusting for differences in demographics, baseline utilization, MPR, and length of therapy (n = 377), the atypical cohort experienced significantly fewer office visits (2,635 vs 4,249 per 1000 patients per month [P1000PPM]; p = 0.005), fewer inpatient admissions (197 vs 511 P1000PPM; p = 0.032), and fewer emergency room visits (125 vs 354 P1000PPM; p = 0.002). Conclusions: Atypical antipsychotic users were significantly more adherent to therapy, and had lower rates of office, hospital and emergency room utilization. Within the context of inherent limitations associated with health insurance claims databases, this study suggests that a relationship exists across cohorts between medication adherence and use of healthcare resources.

Original languageEnglish
Pages (from-to)619-626
Number of pages8
JournalCurrent Medical Research and Opinion
Volume19
Issue number7
DOIs
Publication statusPublished - 2003

Fingerprint

Patient Compliance
Antipsychotic Agents
Delivery of Health Care
Hospital Emergency Service
Office Visits
Medication Adherence
State Health Plans
Inpatients
Therapeutics
Outcome Assessment (Health Care)
Southeastern United States
Health Insurance Reimbursement
Health Insurance
Prescriptions
Cohort Studies
Research Design
Outpatients
Demography
Databases
Health

Keywords

  • Adherence
  • Antipsychotics, atypical, typical
  • Medication possession ratio
  • Persistence
  • Resource utilization

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications. / Al-Zakwani, Ibrahim S.; Barron, John J.; Bullano, Michael F.; Arcona, Steve; Drury, Christopher J.; Cockerham, Tara R.

In: Current Medical Research and Opinion, Vol. 19, No. 7, 2003, p. 619-626.

Research output: Contribution to journalArticle

Al-Zakwani, Ibrahim S. ; Barron, John J. ; Bullano, Michael F. ; Arcona, Steve ; Drury, Christopher J. ; Cockerham, Tara R. / Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications. In: Current Medical Research and Opinion. 2003 ; Vol. 19, No. 7. pp. 619-626.
@article{a39444512b174d3da495c1ce91ebbdcd,
title = "Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications",
abstract = "Objective: To examine the effects of typical and atypical antipsychotics on medication adherence and healthcare resource utilization. Research design and methods: This was a retrospective observational cohort analysis of pharmacy and medical health insurance reimbursement data of patients from a southeastern United States health plan. Pharmacy data of subjects between 6 and 65 years of age were identified. Inclusion criteria included initiation of a single antipsychotic agent between July 1, 1999 and September 30, 2000; no antipsychotic medication usage 6 months prior to the index prescription date; and continuous health plan enrollment for the 18-month study period. Multivariable methods were utilized to analyze healthcare resource utilizations between groups. Outcome measures: Primary outcome measures included: (1) adherence and persistence with antipsychotic therapy; (2) healthcare utilization for outpatient office and hospital visits, inpatient hospital visits, and emergency room visits; and (3) therapy modifications and concomitant medications. Results: A total of 469 patients met initial study criteria. Atypical and typical antipsychotics were prescribed to 384 and 85 patients, respectively. Length of therapy (days) for the atypical cohort was significantly longer (136 vs 80; p <0.001). As defined using medication possession ratio (MPR), the atypical cohort was significantly more adherent to therapy than the typical cohort (mean MPR, 0.53 vs 0.24; p <0.001). After adjusting for differences in demographics, baseline utilization, MPR, and length of therapy (n = 377), the atypical cohort experienced significantly fewer office visits (2,635 vs 4,249 per 1000 patients per month [P1000PPM]; p = 0.005), fewer inpatient admissions (197 vs 511 P1000PPM; p = 0.032), and fewer emergency room visits (125 vs 354 P1000PPM; p = 0.002). Conclusions: Atypical antipsychotic users were significantly more adherent to therapy, and had lower rates of office, hospital and emergency room utilization. Within the context of inherent limitations associated with health insurance claims databases, this study suggests that a relationship exists across cohorts between medication adherence and use of healthcare resources.",
keywords = "Adherence, Antipsychotics, atypical, typical, Medication possession ratio, Persistence, Resource utilization",
author = "Al-Zakwani, {Ibrahim S.} and Barron, {John J.} and Bullano, {Michael F.} and Steve Arcona and Drury, {Christopher J.} and Cockerham, {Tara R.}",
year = "2003",
doi = "10.1185/030079903125002270",
language = "English",
volume = "19",
pages = "619--626",
journal = "Current Medical Research and Opinion",
issn = "0300-7995",
publisher = "Informa Healthcare",
number = "7",

}

TY - JOUR

T1 - Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications

AU - Al-Zakwani, Ibrahim S.

AU - Barron, John J.

AU - Bullano, Michael F.

AU - Arcona, Steve

AU - Drury, Christopher J.

AU - Cockerham, Tara R.

PY - 2003

Y1 - 2003

N2 - Objective: To examine the effects of typical and atypical antipsychotics on medication adherence and healthcare resource utilization. Research design and methods: This was a retrospective observational cohort analysis of pharmacy and medical health insurance reimbursement data of patients from a southeastern United States health plan. Pharmacy data of subjects between 6 and 65 years of age were identified. Inclusion criteria included initiation of a single antipsychotic agent between July 1, 1999 and September 30, 2000; no antipsychotic medication usage 6 months prior to the index prescription date; and continuous health plan enrollment for the 18-month study period. Multivariable methods were utilized to analyze healthcare resource utilizations between groups. Outcome measures: Primary outcome measures included: (1) adherence and persistence with antipsychotic therapy; (2) healthcare utilization for outpatient office and hospital visits, inpatient hospital visits, and emergency room visits; and (3) therapy modifications and concomitant medications. Results: A total of 469 patients met initial study criteria. Atypical and typical antipsychotics were prescribed to 384 and 85 patients, respectively. Length of therapy (days) for the atypical cohort was significantly longer (136 vs 80; p <0.001). As defined using medication possession ratio (MPR), the atypical cohort was significantly more adherent to therapy than the typical cohort (mean MPR, 0.53 vs 0.24; p <0.001). After adjusting for differences in demographics, baseline utilization, MPR, and length of therapy (n = 377), the atypical cohort experienced significantly fewer office visits (2,635 vs 4,249 per 1000 patients per month [P1000PPM]; p = 0.005), fewer inpatient admissions (197 vs 511 P1000PPM; p = 0.032), and fewer emergency room visits (125 vs 354 P1000PPM; p = 0.002). Conclusions: Atypical antipsychotic users were significantly more adherent to therapy, and had lower rates of office, hospital and emergency room utilization. Within the context of inherent limitations associated with health insurance claims databases, this study suggests that a relationship exists across cohorts between medication adherence and use of healthcare resources.

AB - Objective: To examine the effects of typical and atypical antipsychotics on medication adherence and healthcare resource utilization. Research design and methods: This was a retrospective observational cohort analysis of pharmacy and medical health insurance reimbursement data of patients from a southeastern United States health plan. Pharmacy data of subjects between 6 and 65 years of age were identified. Inclusion criteria included initiation of a single antipsychotic agent between July 1, 1999 and September 30, 2000; no antipsychotic medication usage 6 months prior to the index prescription date; and continuous health plan enrollment for the 18-month study period. Multivariable methods were utilized to analyze healthcare resource utilizations between groups. Outcome measures: Primary outcome measures included: (1) adherence and persistence with antipsychotic therapy; (2) healthcare utilization for outpatient office and hospital visits, inpatient hospital visits, and emergency room visits; and (3) therapy modifications and concomitant medications. Results: A total of 469 patients met initial study criteria. Atypical and typical antipsychotics were prescribed to 384 and 85 patients, respectively. Length of therapy (days) for the atypical cohort was significantly longer (136 vs 80; p <0.001). As defined using medication possession ratio (MPR), the atypical cohort was significantly more adherent to therapy than the typical cohort (mean MPR, 0.53 vs 0.24; p <0.001). After adjusting for differences in demographics, baseline utilization, MPR, and length of therapy (n = 377), the atypical cohort experienced significantly fewer office visits (2,635 vs 4,249 per 1000 patients per month [P1000PPM]; p = 0.005), fewer inpatient admissions (197 vs 511 P1000PPM; p = 0.032), and fewer emergency room visits (125 vs 354 P1000PPM; p = 0.002). Conclusions: Atypical antipsychotic users were significantly more adherent to therapy, and had lower rates of office, hospital and emergency room utilization. Within the context of inherent limitations associated with health insurance claims databases, this study suggests that a relationship exists across cohorts between medication adherence and use of healthcare resources.

KW - Adherence

KW - Antipsychotics, atypical, typical

KW - Medication possession ratio

KW - Persistence

KW - Resource utilization

UR - http://www.scopus.com/inward/record.url?scp=0142027147&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0142027147&partnerID=8YFLogxK

U2 - 10.1185/030079903125002270

DO - 10.1185/030079903125002270

M3 - Article

C2 - 14606985

AN - SCOPUS:0142027147

VL - 19

SP - 619

EP - 626

JO - Current Medical Research and Opinion

JF - Current Medical Research and Opinion

SN - 0300-7995

IS - 7

ER -