Adherence to Atypical Antipsychotic Treatment Among Newly Treated Patients
Notice bibliographique
Résumé
BACKGROUND: Lack of adherence to drug treatment is a major obstacle to disease control. Although many studies have examined adherence to antipsychotic treatment, they have generally suffered from lack of differentiation between persistence and compliance as 2 separate components of adherence. OBJECTIVES: In an outpatient population, to (1) measure the proportion of atypical antipsychotic users who were still on antipsychotic treatment after 12 months, (2) measure the proportion of compliant users among them, and (3) identify the determinants of persistence and of compliance. METHOD: We carried out a population-based cohort study using the Quebec Health Insurance Board database. Patients previously diagnosed with schizophrenia (ICD-9 criteria) and initiated on clozapine, olanzapine, quetiapine, or risperidone treatment between January 1, 1997, and August 31, 1999, were included. Patients still undergoing treatment with any atypical antipsychotic drug 1 year after their first prescription were considered persistent. Of these patients, those with a supply of drugs for at least 80% of the days were deemed compliant. To identify the characteristics associated with both outcomes, we built a multivariate logistic regression model using a stepwise procedure and calculated odds ratios and their 95% confidence interval. RESULTS: Of 6662 individuals initiated on treatment with atypical antipsychotics, 4495 (67.5%) were still on the treatment after 1 year, and 3534 (78.6% of those who persisted) were compliant. Patients more likely to be both persistent and compliant were those initiated on clozapine, those who received a treatment of medium or high intensity, those who had used atypical antipsychotics, those without a history of substance-use disorder, and those on welfare. On the other hand, patients who were prescribed their first atypical antipsychotic by a psychiatrist were more likely to be persistent, whereas those with a high comorbidity index and those aged 35 years or more were more likely to be compliant. CONCLUSIONS: One year after treatment initiation, almost a third of patients were no longer treated with atypical antipsychotics. Of those still being treated, more than 20% were noncompliant. Further studies should focus on means of improving such erratic treatment behaviors.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».