Henry A Glick1, Pengxiang Li2, Philip D Harvey3. 1. Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Room 1211 Blockley Hall, Philadelphia, PA 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, 423 Guardian Drive, Room 1211 Blockley Hall, Philadelphia, PA 19104, USA. Electronic address: hlthsvrs@mail.med.upenn.edu. 2. Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Room 1213 Blockley Hall, Philadelphia, PA 19104, USA. Electronic address: penli@mail.med.upenn.edu. 3. University of Miami Miller School of Medicine Research Service, Bruce W. Carter VA Medical Center, Clinical Research Building, 1120 NW 14th St, 14th flr, Miami, FL 33136, USA. Electronic address: pharvey@med.miami.edu.
Abstract
BACKGROUND: Little is known about the effect of treatment-related changes in Positive and Negative Syndrome Scale (PANSS) schizophrenia severity scores on the risk for subsequent hospitalization. METHODS: We used limited-access data from the Clinical Antipsychotic Trials of Intervention Effectiveness Project Schizophrenia Trial (CATIE Sz) to evaluate the relationship between baseline and changes in PANSS clinical symptom scores and risks for subsequent psychiatric hospitalization. RESULTS: Reductions in PANSS total scores during a three-month period were associated with a significantly lower risk for psychiatric hospitalization (OR, 0.78, 95% CI, 0.72 to 0.84, p<0.001 for 10 point reductions). Ten-point reductions in PANSS total score during three months reduced predicted number of psychiatric hospitalizations by 0.02 (95% CI, 0.012 to 0.027) and nights in the hospital by 0.24 (95% CI, 0.07 to 0.41). Maintenance of this reduction for a year is expected to reduce psychiatric hospitalizations by 0.10 (95% CI, 0.08 to 0.13) and nights hospitalized by 1.4 (95% CI, 0.9 to 1.9). A 10-point reduction in PANSS total score was associated with a savings in psychiatric hospitalization cost of $192 over three months and $1135 over a year. CONCLUSIONS: Reductions in PANSS total scores significantly reduced risks for psychiatric hospitalizations, total number of psychiatric hospitalizations, total nights for psychiatric admissions, and the costs of these hospitalizations. These data highlight the benefits of symptom control on the direct costs of care in schizophrenia.
RCT Entities:
BACKGROUND: Little is known about the effect of treatment-related changes in Positive and Negative Syndrome Scale (PANSS) schizophrenia severity scores on the risk for subsequent hospitalization. METHODS: We used limited-access data from the Clinical Antipsychotic Trials of Intervention Effectiveness Project Schizophrenia Trial (CATIE Sz) to evaluate the relationship between baseline and changes in PANSS clinical symptom scores and risks for subsequent psychiatric hospitalization. RESULTS: Reductions in PANSS total scores during a three-month period were associated with a significantly lower risk for psychiatric hospitalization (OR, 0.78, 95% CI, 0.72 to 0.84, p<0.001 for 10 point reductions). Ten-point reductions in PANSS total score during three months reduced predicted number of psychiatric hospitalizations by 0.02 (95% CI, 0.012 to 0.027) and nights in the hospital by 0.24 (95% CI, 0.07 to 0.41). Maintenance of this reduction for a year is expected to reduce psychiatric hospitalizations by 0.10 (95% CI, 0.08 to 0.13) and nights hospitalized by 1.4 (95% CI, 0.9 to 1.9). A 10-point reduction in PANSS total score was associated with a savings in psychiatric hospitalization cost of $192 over three months and $1135 over a year. CONCLUSIONS: Reductions in PANSS total scores significantly reduced risks for psychiatric hospitalizations, total number of psychiatric hospitalizations, total nights for psychiatric admissions, and the costs of these hospitalizations. These data highlight the benefits of symptom control on the direct costs of care in schizophrenia.
Authors: Arun Singh; Srihari Gopal; Edward Kim; Maju Mathews; Jennifer Kern-Sliwa; Ibrahim Turkoz; Annette Wooller; Jesse Berlin Journal: Int Clin Psychopharmacol Date: 2018-07 Impact factor: 1.659