Clinical Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study.

Heo, Jung Un; Kim, Dong Wook; Oh, Seung Taek; Choi, Won Jung; Park, Jaesub

doi:2019.22.2.42

Korean J Schizophr Res > Volume 22(2); 2019 > Article

Original Article

Korean Journal of Schizophrenia Research 2019;22(2):42-50.
DOI: https://doi.org/10.16946/kjsr.2019.22.2.42 Published online October 31, 2019.

Clinical Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study.

Jung Un Heo, Dong Wook Kim, Seung Taek Oh, Won Jung Choi, Jaesub Park

¹Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea. psy.ilsan@nhimc.or.kr
²Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
³Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.
⁴Yonsei Hana Psychiatry Clinic and Institute of Mental Health, Goyang, Korea.

Abstract

OBJECTIVES
In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use.
METHODS
All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8).
RESULTS
Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40–60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001).
CONCLUSION
These findings suggest that patients in the 20s and 30s with the 40–60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

Key Words: Antipsychotics · Drug adherence · Medical use · Psychotic disorder