Real-World Characteristics of U.S. Patients Living with Schizophrenia or Schizoaffective Disorder Who Experience Relapse

Abstract: Relapse (i.e., acute exacerbations of symptoms) is common among patients living with schizophrenia leading to employment, economic, and social instability. The objective of this study was to understand patient characteristics related to frequent relapse. Patients ≥12 years with naïve schizophrenia or schizoaffective disorder diagnoses (index date) between 01/01/2014 and 08/31/2020 were retrospectively identified from the HealthCore Integrated Research Database®. Patients were continuously enrolled in commercial or Medicare Advantage/Supplemental (Medigap)/Part D insurance plans for one year before and after the index date. Three cohorts were created based on the frequency of relapses (defined as inpatient encounters for schizophrenia/schizoaffective disorder or emergency room encounters for psychiatric disorders) within one-year post-index: 0 relapses, 1 relapse, and ≥2 relapses. Among the 6,634 patients included, 74% experienced 0 relapses (median age 37 years; 55% male), 17% experienced 1 relapse (median age 37 years; 58% male), and 10% experienced ≥2 relapses (median age 37 years; 51% male). Prevalence of baseline behavioral health comorbidities including substance use (0 relapses: 16%; 1 relapse: 25%; ≥2 relapses: 32%), anxiety (38%; 42%; 52%), and depression (39%; 43%; 54%), were highest in the ≥2 relapse cohort. Post-index total mean daily pill burden (6; 7; 9; p < 0.01) and antipsychotic use (75%; 85%; 90%; p < 0.01) significantly differed across cohorts. In conclusion, patient characteristics varied by cohort; the ≥2 relapse cohort had the highest prevalence of behavioral health comorbidities and pharmacotherapy use. These results provide further understanding of patient characteristics by relapse frequency, which can be leveraged to develop strategies aimed at minimizing relapses.Short Description: The study characterizes U.S. patients living with schizophrenia and schizoaffective disorder with commercial and Medicare Advantage/Supplemental (Medigap)/Part D insurance who experience relapses. Results from the study found that patients who had more frequent relapses (≥2 relapses) had a higher prevalence of behavioral health comorbidities and pharmacotherapy use than patients with less frequent (1 relapse) or no relapses (0 relapses).Name of Sponsoring Organization(s): Boehringer Ingelheim Pharmaceuticals, Inc.