Psychiatric inpatient healthcare resource utilization and treatment patterns among patients with predominant negative symptoms in schizophrenia

Abstract: Currently-approved treatments for schizophrenia have demonstrated effectiveness for treating positive symptoms. There is a need to develop effective treatments for negative symptoms, which if left untreated, may indicate a poorer clinical course. We examined inpatient healthcare resource utilization in patients with schizophrenia experiencing predominantly negative symptoms (PNS). De-identified data were extracted from electronic health records in the NeuroBlu Database across 25 US mental healthcare providers. Positive and negative symptom data were derived from free-text records using natural language processing. PNS was defined as the presence of three or more negative symptoms and three or fewer positive symptoms at first clinical contact following schizophrenia diagnosis. Groups were balanced for baseline demographic and clinical characteristics by minimizing the generalized Mahalanobis distance and compared using chi-square and t-tests. Treatment patterns were visualized using Sankey diagrams. A total of 4,444 patients with schizophrenia were identified and 8% were classified as experiencing PNS. A balanced cohort of 720 patients (50% PNS) was generated. Patients with PNS were more likely to be hospitalized in the 12 months following diagnosis than non-PNS patients (PNS: 76%, non-PNS: 60%, χ2: 22.5, p < 0.001) and were switched to a second-line antipsychotic after a shorter first-line treatment duration. The most frequently prescribed antipsychotics differed between groups. This study demonstrates that negative symptoms in schizophrenia may be associated with worse illness course and higher healthcare resource utilization. There remains a need for new treatment options for patients with negative symptoms which specifically improve this historically hard-to-treat and assess symptom domain.Short Description: Abstract summary: This study applied natural language processing to de-identified electronic health record data to identify two matched groups of patients with schizophrenia who presented with or without predominantly negative symptoms (PNS). Group differences in healthcare resource utilization and antipsychotic treatment patterns were investigated. Patients with PNS were more likely to be hospitalized compared to those without PNS and antipsychotic treatment patterns between the two groups varied.Name of Sponsoring Organization(s): Sunovion Pharmaceuticals