Assessment Of Quality Of Life, Economic And Clinical Outcomes Among Patients With Schizophrenia In Universiti Kebangsaan Malaysia Medical Centre

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Date
2011-03
Authors
Taha, Nur Akmar
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Publisher
Universiti Sains Malaysia
Abstract
Schizophrenia is a chronic and serious mental illness that occurs early and persists for a lifetime. It has significant personal, social & economic impact on the patients, families and society. The objective of the study was to determine and compare the impact of different types of antipsychotic maintenance treatment on humanistic, economic and clinical outcomes in routine clinical practice. The study was prospective and observational in nature. Patients were grouped into two treatment groups; atypical and typical treatment group and assessed at baseline, 3, 6 and 12 months. Health-related quality of life (HRQoL) outcomes were assessed by disease specific scale, the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) and generic scale, the EuroQoL Group EQ-5D. Clinical outcomes were assessed using the Clinical Global Impressions-Schizophrenia (CGI-SCH) severity scale, the Approaches to Schizophrenia Communication Clinician Interview Version (ASC-C) side-effect checklist and prescription refills for antipsychotic adherence. Cost-effectiveness analysis and cost-utility analysis were calculated for each treatment group. The incremental cost effectiveness (ICER) was determined for atypical antipsychotic relative to typical antipsychotic drug. There were 159 patients who completed the study. Patients on atypical antipsychotic treatment were younger, mainly single and tend to have higher academic qualifications than patients on typical antipsychotics. The SQLS-R4 was a valid and reliable HRQoL scale (Cronbach’s  = 0.95 and 0.85 for psychosocial and vitality subscale, respectively; item to total correlations ranged from 0.45 to 0.7). There was no significant difference in the mean SQLS-R4 overall scores between the treatment groups. The estimated adjusted ICER for atypical antipsychotics relative to typical antipsychotics was MYR85 575.44 per unit improved in CGI-SCH overall score and MYR770 179 per QALY gained. The ICER was sensitive to acquisition costs of antipsychotic drugs.
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Keywords
Assessment of quality of life , among patients with schizophrenia
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