Linus Jönsson1,2, Jacob Simonsen1, Cecilia Brain1, Steven Kymes3, Louise Watson1. 1. Research & Development, H. Lundbeck A/S, Valby, Denmark. 2. Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. 3. Health Economics & Outcomes Research, H. Lundbeck Inc., Deerfield, Illinois.
Abstract
OBJECTIVES: Treatment-resistant schizophrenia (TRS) is clinically defined as failure to respond to two antipsychotics of adequate dose and duration. An algorithm (registry TRS) was developed, for identifying patients with TRS in claim datasets from Sweden and the United States. METHODS: Schizophrenia (SZ) patients aged ≥13 years were identified in both datasets and matched to controls. Patients were identified as having TRS by use of the registry TRS or ≥1 prescription for clozapine or use of other published criteria. The algorithm was compared for sensitivity, and patients with and without TRS were compared for psychiatric and hospital burden and Global Assessment of Functioning (GAF) scores. TRS prevalence was not assessed due to lack of clinically validated data to test the specificity of the algorithm. RESULTS: Swedish registry TRS patients ≤45 years at first SZ diagnosis had significantly lower GAF scores and earlier disease onset than non-TRS patients. SZ patients with higher psychiatric comorbidity and hospital burden were more likely identified as TRS by all algorithms. The registry algorithm was significantly more sensitive to multiple inpatient stays and all psychiatric comorbidities at identifying TRS. CONCLUSION: The registry algorithm appeared more sensitive at identifying patients with TRS, who had greater psychiatric and hospital burden.
OBJECTIVES: Treatment-resistant schizophrenia (TRS) is clinically defined as failure to respond to two antipsychotics of adequate dose and duration. An algorithm (registry TRS) was developed, for identifying patients with TRS in claim datasets from Sweden and the United States. METHODS:Schizophrenia (SZ) patients aged ≥13 years were identified in both datasets and matched to controls. Patients were identified as having TRS by use of the registry TRS or ≥1 prescription for clozapine or use of other published criteria. The algorithm was compared for sensitivity, and patients with and without TRS were compared for psychiatric and hospital burden and Global Assessment of Functioning (GAF) scores. TRS prevalence was not assessed due to lack of clinically validated data to test the specificity of the algorithm. RESULTS: Swedish registry TRS patients ≤45 years at first SZ diagnosis had significantly lower GAF scores and earlier disease onset than non-TRS patients. SZ patients with higher psychiatric comorbidity and hospital burden were more likely identified as TRS by all algorithms. The registry algorithm was significantly more sensitive to multiple inpatient stays and all psychiatric comorbidities at identifying TRS. CONCLUSION: The registry algorithm appeared more sensitive at identifying patients with TRS, who had greater psychiatric and hospital burden.
Authors: A Demjaha; J M Lappin; D Stahl; M X Patel; J H MacCabe; O D Howes; M Heslin; U A Reininghaus; K Donoghue; B Lomas; M Charalambides; A Onyejiaka; P Fearon; P Jones; G Doody; C Morgan; P Dazzan; R M Murray Journal: Psychol Med Date: 2017-04-11 Impact factor: 7.723
Authors: J Lally; O Ajnakina; M Di Forti; A Trotta; A Demjaha; A Kolliakou; V Mondelli; T Reis Marques; C Pariante; P Dazzan; S S Shergil; O D Howes; A S David; J H MacCabe; F Gaughran; R M Murray Journal: Psychol Med Date: 2016-09-08 Impact factor: 7.723
Authors: David M Gardner; Andrea L Murphy; Heather O'Donnell; Franca Centorrino; Ross J Baldessarini Journal: Am J Psychiatry Date: 2010-04-01 Impact factor: 18.112
Authors: Oliver D Howes; Francis Vergunst; Siobhan Gee; Philip McGuire; Shitij Kapur; David Taylor Journal: Br J Psychiatry Date: 2012-09-06 Impact factor: 9.319
Authors: Linus Jönsson; Jacob Simonsen; Cecilia Brain; Steven Kymes; Louise Watson Journal: Int J Methods Psychiatr Res Date: 2019-04-07 Impact factor: 4.035
Authors: Daniela Fonseca de Freitas; Giouliana Kadra-Scalzo; Deborah Agbedjro; Emma Francis; Isobel Ridler; Megan Pritchard; Hitesh Shetty; Aviv Segev; Cecilia Casetta; Sophie E Smart; Johnny Downs; Søren Rahn Christensen; Nikolaj Bak; Bruce J Kinon; Daniel Stahl; James H MacCabe; Richard D Hayes Journal: J Psychopharmacol Date: 2022-02-25 Impact factor: 4.562
Authors: Giouliana Kadra-Scalzo; Daniela Fonseca de Freitas; Deborah Agbedjro; Emma Francis; Isobel Ridler; Megan Pritchard; Hitesh Shetty; Aviv Segev; Cecilia Casetta; Sophie E Smart; Anna Morris; Johnny Downs; Søren Rahn Christensen; Nikolaj Bak; Bruce J Kinon; Daniel Stahl; Richard D Hayes; James H MacCabe Journal: PLoS One Date: 2022-09-19 Impact factor: 3.752
Authors: Renato de Filippis; Raffaele Gaetano; Georgios Schoretsanitis; Giuseppe Verde; Cesare Anthony Oliveti; John M Kane; Cristina Segura-Garcia; Pasquale De Fazio Journal: Neuropsychiatr Dis Treat Date: 2021-07-01 Impact factor: 2.570