Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-25T08:15:39.889Z Has data issue: false hasContentIssue false
  • English
  • Français

The Schizophrenia Outpatient Health Outcomes (SOHO) study: 3-year results of antipsychotic treatment discontinuation and related clinical factors in Spain

Published online by Cambridge University Press:  16 April 2020

Antonio Ciudad ,
Josep María Haro ,
Jordi Alonso ,
Manuel Bousoño ,
David Suárez ,
Diego Novick  and
Inmaculada Gilaberte
Antonio Ciudad*
Affiliation:
Clinical Research, Department of Research and Development, Lilly, S.A. Avda. de la Industria, 30, 28108Alcobendas (Madrid), Spain
Josep María Haro
Affiliation:
Fundación San Juan de Dios, 08830 Sant Boi de Llobregat, Barcelona, Spain
Jordi Alonso
Affiliation:
Health Sciences Research Unit, IMIM – Hospital del Mar, 08003Barcelona, Spain
Manuel Bousoño
Affiliation:
Department of Psychiatry, University of Oviedo, 33006 Oviedo, Asturias, Spain
David Suárez
Affiliation:
Fundación San Juan de Dios, 08830 Sant Boi de Llobregat, Barcelona, Spain
Diego Novick
Affiliation:
European Health Outcomes Research, Eli Lilly and Company Limited, Windlesham, Surrey, UK
Inmaculada Gilaberte
Affiliation:
Clinical Research, Department of Research and Development, Lilly, S.A. Avda. de la Industria, 30, 28108Alcobendas (Madrid), Spain
*
*Corresponding author. Tel.: +34 91 663 50 00. E-mail address: [email protected] (A. Ciudad).
Get access

Abstract

Introduction

This article presents the long-term results in terms of antipsychotic medication maintenance and factors influencing it in a representative sample of patients with schizophrenia recruited in the SOHO study within Spain.

Methods

The SOHO was a prospective, 3-year observational study of the outcomes of schizophrenia treatment in outpatients who initiated therapy or changed to a new antipsychotic performed in 10 European countries with a focus on olanzapine. The Kaplan–Meier method was used to analyse the time to treatment discontinuation and the Cox proportional hazards model to investigate correlates of discontinuation.

Results and conclusions

In total, 1688 patients were included in the analyses. Medication maintenance at 3 years varied with the antipsychotic prescribed, being highest with clozapine (57.6%, 95% CI 39.2–74.5), followed by olanzapine (48.3%, 95% CI 45.1–51.5); and lowest with quetiapine (19.0%, 95% CI 13.0–26.3). Treatment discontinuation was significantly less frequent with olanzapine than with risperidone (p = 0.015), depot typical (p = 0.001), oral typical antipsychotics (p < 0.001) or quetiapine (p < 0.001); but not than with clozapine (p = 0.309). Longer maintenance was also associated with higher social abilities and better cognitive status at baseline; in contrast, a shorter time to discontinuation was associated with the need for mood stabilisers during follow-up. This study emphasises the different value of antipsychotics in day-to-day clinical practice, as some of them were associated with longer medication maintenance periods than others. This study has some limitations because of possible selection and information biases derived from the non-systematic, non-randomised allocation to treatments and the existence of unobserved covariates that may influence the outcome.

Keywords

SchizophreniaAntipsychotic agentsOutcome assessmentHealth care surveysProspective studies
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 1 , January 2008 , pp. 1 - 7
Copyright
Copyright © Elsevier Masson SAS 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ascher-Svanum, H., Faries, D.E., Zhu, B., Ernst, F.R., Swartz, M.S., Swanson, J.W.Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry 2006;67:453–460CrossRefGoogle ScholarPubMed
Ascher-Svanum, H., Zhu, B., Faries, D., Landbloom, R., Swartz, M., Swanson, J.Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia. BMC Psychiatry 2006;6:8CrossRefGoogle ScholarPubMed
Citrome, L., Jaffe, A., Levine, J., Lindenmayer, J.P.Dosing of quetiapine in schizophrenia: how clinical practice differs from registration studies. J Clin Psychiatry 2005;66:1512–1516CrossRefGoogle ScholarPubMed
Coley, K.C., Carter, C.S., DaPos, S.V., Maxwell, R., Wilson, J.W., Branch, R.A.Effectiveness of antipsychotic therapy in a naturalistic setting: a comparison between risperidone, perphenazine, and haloperidol. J Clin Psychiatry 1999;60:850–856CrossRefGoogle Scholar
Conley, R.R., Love, R.C., Kelly, D.L., Bartko, J.J.Rehospitalization rates of patients recently discharged on a regimen of risperidone or clozapine. Am J Psychiatry 1999;156:863–868CrossRefGoogle ScholarPubMed
Chakos, M., Lieberman, J., Hoffman, E., Bradford, D., Sheitman, B.Effectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: a review and meta-analysis of randomized trials. Am J Psychiatry 2001;158:518–526CrossRefGoogle ScholarPubMed
Dossenbach, M., Arango-Davila, C., Silva Ibarra, H., Landa, E., Aguilar, J., Caro, O.et al.Response and relapse in patients with schizophrenia treated with olanzapine, risperidone, quetiapine, or haloperidol: 12-month follow-up of the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study. J Clin Psychiatry 2005;66:1021–1030CrossRefGoogle ScholarPubMed
Dossenbach, M., Dyachkova, Y., Pirildar, S., Anders, M., Khalil, A., Araszkiewicz, A.et al.Effects of atypical and typical antipsychotic treatments on sexual function in patients with schizophrenia: 12-month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study. Eur Psychiatry 2006;21:251–258CrossRefGoogle ScholarPubMed
Dossenbach, M., Erol, A., el Mahfoud Kessaci, M., Shaheen, M.O., Sunbol, M.M., Boland, J.et al.Effectiveness of antipsychotic treatments for schizophrenia: interim 6-month analysis from a prospective observational study (IC-SOHO) comparing olanzapine, quetiapine, risperidone, and haloperidol. J Clin Psychiatry 2004;65:312–321CrossRefGoogle ScholarPubMed
Dossenbach, M.R., Kratky, P., Schneidman, M., Grundy, S.L., Metcalfe, S., Tollefson, G.D.et al.Evidence for the effectiveness of olanzapine among patients nonresponsive and/or intolerant to risperidone. J Clin Psychiatry 62Suppl 22001 28–34Google ScholarPubMed
Droulout, T., Liraud, F., Verdoux, H.Relationships between insight and medication adherence in subjects with psychosis. L'Encephale 2003;29:430–437 (in French)Google ScholarPubMed
Essock, S.M., Covell, N.H., Davis, S.M., Stroup, T.S., Rosenheck, R.A., Lieberman, J.A.Effectiveness of switching antipsychotic medications. Am J Psychiatry 2006;163:2090–2095CrossRefGoogle ScholarPubMed
Gaebel, W.Towards the improvement of compliance: the significance of psycho-education and new antipsychotic drugs. Int Clin Psychopharmacol 12Suppl 11997 S37–S42CrossRefGoogle ScholarPubMed
Haro, J.M., Edgell, E.T., Jones, P.B., Alonso, J., Gavart, S., Gregor, K.J.et al.The European Schizophrenia Outpatient Health Outcomes (SOHO) study: rationale, methods and recruitment. Acta Psychiatr Scand 2003;107:222–232CrossRefGoogle ScholarPubMed
Haro, J.M., Kamath, S.A., Ochoa, S., Novick, D., Rele, K., Fargas, A.et al.The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia. Acta Psychiatr Scand 2003;107:16–23CrossRefGoogle Scholar
Haro, J.M., Novick, D., Belger, M., Jones, P.B.Antipsychotic type and correlates of antipsychotic treatment discontinuation in the outpatient treatment of schizophrenia. Eur Psychiatry 2006;21:41–47CrossRefGoogle ScholarPubMed
Haro, J.M., Suarez, D., Novick, D., Brown, J., Usall, J., Naber, D.Three-year antipsychotic effectiveness in the outpatient care of schizophrenia: observational versus randomized studies results. Eur Neuropsychopharmacol 2007;17:235–244CrossRefGoogle ScholarPubMed
Ho, B.C., Miller, D., Nopoulos, P., Andreasen, N.C.A comparative effectiveness study of risperidone and olanzapine in the treatment of schizophrenia. J Clin Psychiatry 1999;60:658–663CrossRefGoogle ScholarPubMed
Lehman, A.F., Lieberman, J.A., Dixon, L.B., McGlashan, T.H., Miller, A.L., Perkins, D.O.et al.Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry 2004;161:1–56 second editionGoogle ScholarPubMed
Lieberman, J.A., Stroup, T.S., McEvoy, J.P., Swartz, M.S., Rosenheck, R.A., Perkins, D.O.et al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005;353:1209–1223CrossRefGoogle ScholarPubMed
Robinson, D.G., Woerner, M.G., Alvir, J.M., Bilder, R.M., Hinrichsen, G.A., Lieberman, J.A.Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder. Schizophrenia Res 2002;57:209–219CrossRefGoogle ScholarPubMed
Schooler, N.R.Relapse prevention and recovery in the treatment of schizophrenia. J Clin Psychiatry 67Suppl 52006 19–23Google ScholarPubMed
Sullivan, G., Wells, K.B., Morgenstern, H., Leake, B.Identifying modifiable risk factors for rehospitalization: a case-control study of seriously mentally ill persons in Mississippi. Am J Psychiatry 1995;152:1749–1756Google ScholarPubMed
Valenstein, M., Copeland, L.A., Blow, F.C., McCarthy, J.F., Zeber, J.E., Gillon, L.et al.Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care 2002;40:630–639CrossRefGoogle ScholarPubMed
Wahlbeck, K., Tuunainen, A., Ahokas, A., Leucht, S.Dropout rates in randomised antipsychotic drug trials. Psychopharmacology 2001;155:230–233CrossRefGoogle ScholarPubMed
Weiss, K.A., Smith, T.E., Hull, J.W., Piper, A.C., Huppert, J.D.Predictors of risk of nonadherence in outpatients with schizophrenia and other psychotic disorders. Schizophrenia Bull 2002;28:341–349CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.