One-Third of Veterans With Schizophrenia Receive No Antipsychotic Treatment Postdiagnosis

Nearly one-third of US veterans with a new diagnosis of schizophrenia received no antipsychotic medication to manage their symptoms, according to a study published in Advances in Therapy. Those who did receive an antipsychotic prescription waited weeks after their diagnosis.

“These data indicate that pharmacotherapy after a recent diagnosis of schizophrenia in the Veterans Health Administration (VHA) system is suboptimal, and that these patients face a considerable burden in terms of hospitalization, other health care resource utilization, and health care costs,” wrote lead and corresponding author Charmi Patel, MPH, RN, of Janssen Scientific Affairs, and coauthors.

The study included 20,389 adults with a new schizophrenia diagnosis in the VHA database. Patients were enrolled in the VHA for at least 12 months after diagnosis so researchers could follow their health care journey.

Despite being diagnosed with schizophrenia, 32.1% of patients did not receive an antipsychotic prescription during follow-up, according to the study. Among patients with an antipsychotic prescription fill, 64% were prescribed oral antipsychotics and 11.6% were prescribed a long-acting injectable antipsychotic.

Delays between diagnosis and treatment were common: patients prescribed oral antipsychotics waited 39.0 ± 67.2 days, and patients prescribed a long-acting injectable antipsychotic waited 69.4 ± 96.2 days. Adherence, defined as proportion of days covered of at least 80%, was 34.5% with long-acting injectable and 27.3% with oral antipsychotics.

Over the 12 months following schizophrenia diagnosis, 33.8% of patients had an inpatient hospital stay and 5.5% had hospital readmissions.

“All-cause inpatient stay costs with 12-month follow-up equaled $7999 per patient per year,” researchers reported.

Reference:
Patel C, Huang A, Wang L, Paliwal Y, Joshi K. Patient journey of veterans with schizophrenia: an analysis of treatment patterns, healthcare resource utilization and costs. Adv Ther. 2022;39(3):1199-1214. doi:10.1007/s12325-021-01997-z