Clinical Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study

Jung Un Heo; Dong Wook Kim; Seung-Taek Oh; Won-Jung Choi; Jaesub Park

doi:10.16946/kjsr.2019.22.2.42

Journal List > Korean J Schizophr Res > v.22(2) > 1136567

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Heo, Kim, Oh, Choi, and Park: Clinical Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study

Original Article

Korean Journal of Schizophrenia Research 2019; 22(2): 42-50.

Published online: 31 October 2019

DOI: https://doi.org/10.16946/kjsr.2019.22.2.42

Clinical Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study

Jung Un Heo, MD^1,³, Dong Wook Kim, PhD², Seung-Taek Oh, MD^1,³, Won-Jung Choi, MD^3,⁴, Jaesub Park, MD^1,³

¹Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

²Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

³Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.

⁴Yonsei Hana Psychiatry Clinic and Institute of Mental Health, Goyang, Korea.

Address for correspondence: Address for correspondence: Jaesub Park, Department of Psychiatry, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea. Tel: 031-900-0432, Fax: 031-900-0343, psy.ilsan@nhimc.or.kr

Received 4 June 2019 Revised 18 June 2019 Accepted 29 August 2019

Korean Society for Schizophrenia Research

Abstract

Objectives

In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use.

Methods

All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8).

Results

Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40–60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001).

Conclusion

These findings suggest that patients in the 20s and 30s with the 40–60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

Keywords: Antipsychotics, Drug adherence, Medical use, Psychotic disorder

Figures and Tables

Fig. 1

The flow chart of study enrolment.

Fig. 2

Average Medication Possession Ratio (MPR) by income segment and age.

Fig. 3

Average medical and psychiatric costs over time.

Table 1

Distribution of patients first diagnosed with psychotic disorder

F20: schizophrenia, F22: delusional disorder, F23: acute and transient psychotic disorder, F24: induced delusional disorder, F25: schizoaffective disorder, F28: other nonorganic psychotic disorder, F29: unspecified nonorganic psychosis

Table 2

Distribution of patients first diagnosed with psychotic disorder by age

Table 3

Distribution of patients first diagnosed with psychotic disorder by age and income

Table 4

Distribution of mean medication possession ratio by diagnosis

Table 5

Average cost of psychiatric and medical use, average number of psychiatric hospitalizations, period of psychiatric hospitalizations and hospital visits

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