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Quality of life and treatment costs in schizophrenic outpatients, treated with depot neuroleptics

Published online by Cambridge University Press:  16 April 2020

M.Z. Dernovsek ,
V. Prevolnik Rupel ,
M. Rebolj  and
R. Tavcar
M.Z. Dernovsek*
Affiliation:
University Psychiatric Hospital, Studenec 48, SI-1260Ljubljana-Polje, Slovenia
V. Prevolnik Rupel
Affiliation:
Ministry of Health, Stefanova 5, SI-1000Ljubljana, Slovenia
M. Rebolj
Affiliation:
School of Economics, Kardeljeva ploscad 17, SI-1000Ljubljana, Slovenia
R. Tavcar
Affiliation:
University Psychiatric Hospital, Studenec 48, SI-1260Ljubljana-Polje, Slovenia
*
*Correspondence and reprints. E-mail address:[email protected] (M.Z. Dernovsek).
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Summary

Study aim was 1) to find out the influences on quality of life (QoL) of chronic outpatients with schizophrenia; 2) to calculate Quality Adjusted Life Years (QALY); and 3) to estimate direct 1-year treatment costs. In a 20% sample (100 males, 100 females) of schizophrenic outpatients from the Outpatients Clinic in Ljubljana, Slovenia receiving depot neuroleptics demographic, clinical, and treatment data were collected for the year 1996. The Krawiecka Scale, Global Assessment Scale (GAS), Abnormal Involuntary Movement Scale, Rating Scale for Drug-Induced Akathisia, Rating Scale for Extrapyramidal Side Effects, Quality of Life Scale (QLS), EQ-5D and QALY were used. Multivariate linear regression was used with the QLS score as dependent variable. The patients were on average 44 years old and had been treated for 14 years. The average GAS score was 70. GAS was positively related to the QLS score while the parkinsonism score was inversely correlated with QLS. The patients can expect to live for 10. 20 more QALY on average. The QoL on the EQ-5D scale was 0.73. The annual direct treatment costs amounted to $216,216 in 1996 prices. In well-adjusted chronic patients with schizophrenia the QoL seems to depend mostly on their psychosocial performance and side effects. Although rare, rehospitalisations accounted for one-half of all treatment expenses.

Keywords

outpatientsquality of liferehospitalisationschizophrenia
Type
Original Articles
Information
European Psychiatry , Volume 16 , Issue 8 , December 2001 , pp. 474 - 482
Copyright
Copyright © 2001 Éditions scientifiques et médicales Elsevier SAS

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References

American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry 1997; 154 (Suppl): 1–63.CrossRefGoogle Scholar
Attikisson, CCook, JKarno, MLehman, AMcGlashan, THMeltzer, HY.Caring for people with severe mental disorders: clinical services research. Schizophr Bull 1992; 18: 561–626.CrossRefGoogle Scholar
Awad, AG.Quality of life of schizophrenic patients on medications and implications for new drug trials. Hosp Community Psychiatry 1992; 43: 262–5.Google ScholarPubMed
Awad, AGHogan, TP.Subjective response to neuroleptics and the quality of life: implications for treatment outcome. Acta Psychiatr Scand 89Suppl 3801994 27–31.CrossRefGoogle Scholar
Bank of Slovenia. Bilten Banke Slovenije 1997; 6: 10.Google Scholar
Barnes, TRE.A rating scale for drug induced akathisia. Br J Psychiatry 1989; 154: 672–6.CrossRefGoogle ScholarPubMed
Bellack, ASMorrison, RLWixted, JTMueser, KT.An analysis of social competence in schizophrenia. Br J Psychiatry 1990; 156: 809–18.CrossRefGoogle Scholar
Bobes, JGutierrez, MGibert, JGonzalez, MPHerraiz, LFernandez, A.Quality of life in schizophrenia: long-term follow-up in 362 chronic Spanish schizophrenic outpatients undergoing risperidone maintenance treatment. Eur Psychiatry 1998; 13: 158–63.CrossRefGoogle ScholarPubMed
Browne, SClarke, MGervin, MWaddington, JLLarkin, CO’Callaghan, E.Quality of life after treatment for a first presentation of schizophrenia. Schizophr Res 41Suppl2000 301.CrossRefGoogle Scholar
Casey, DE.Motor and mental aspects of acute extrapyramidal syndromes. Acta Psychiatr Scand 1994; 89 (Suppl 380): 14–20.CrossRefGoogle Scholar
Doyle, MFlanagan, SBrowne, SClarke, MLydon, DLarkin, C. et al. Subjective and external assessments of quality of life in schizophrenia: relationship to insight. Acta Psychiatr Scand 1999; 99: 466–72.CrossRefGoogle ScholarPubMed
Endicott, JSpitzer, RLFleiss, JLCohen, JC.The global assessment scale – a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976; 33: 766–71.CrossRefGoogle ScholarPubMed
EuroQol EQ-5D. User guide: version B. Rotterdam: EuroQol Office; 1998.Google Scholar
Evans, RW.Quality of life. Lancet 1991; 338: 636.CrossRefGoogle Scholar
Foster, RHGoa, KL.Olanzapine. A pharmacoeconomic review of its use in schizophrenia. Pharmacoeconomics 1999; 15: 611–40.CrossRefGoogle Scholar
Gudex, CKind, Pvan Dalen, HDurand, MAMorris, JWilliams, A.Comparing scaling methods for health state valuations – Rosser revisited. Discussion paper 107. Centre for Health Economics York 1993.Google Scholar
Halford, WKHayes, RL.Social skills in schizophrenia: assessing the relationship between social skills, psychopathology and community functioning. Soc Psychiatry Psychiatr Epidemiol 1995; 30: 14–9.CrossRefGoogle ScholarPubMed
Hargreaves, WAShumway, MHu, TCuffel, B.Cost-outcome methods for mental health. San Diego: Academic Press; 1998. 160–162.Google Scholar
Harwood, REbrahim, S.Quality of life. Lancet 1991; 338: 637.Google Scholar
Heinrichs, DWHanlon, TECarpenter, WT.The quality of life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984; 10: 388–98.CrossRefGoogle ScholarPubMed
Heslegrave, RJVoruganti, LNPAwad, AG.Neuropsychiatric correlates of quality of life in psychiatry in schizophrenia. Schizophr Res 1995; 12: 216–7.CrossRefGoogle Scholar
Johnson, DAWWright, NF.Drug prescribing for schizophrenic out-patients on depot injections. Br J Psychiatry 1990; 156: 827–34.CrossRefGoogle ScholarPubMed
Kissling, W.Compliance, quality assurance and standards for relapse prevention in schizophrenia. Acta Psychiatr Scand 1994; 89 (Suppl 382): 16–24.CrossRefGoogle Scholar
Knapp, M.Costs of schizophrenia. Br J Psychiatry 1997; 171: 509–18.CrossRefGoogle ScholarPubMed
Koopmanschap, MARutten, FFHvan Ineveld, BMvan Roijen, L.The friction cost method for measuring indirect costs of disease. J Health Econ 1995; 14: 171–89.CrossRefGoogle ScholarPubMed
Krawiecka, MGoldberg, DVaughan, M.A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatr Scand 1977; 55: 299–308.CrossRefGoogle ScholarPubMed
Larsen, EBGerlach, J.Subjective experience of treatment, side effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics. Acta Psychiatr Scand 1996; 93: 381–8.CrossRefGoogle ScholarPubMed
Meltzer, HYBurnett, SBastani, BRamirez, L.F.Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hosp Community Psychiatry 1990; 41: 892–7.Google ScholarPubMed
Meltzer, HY.Dimensions of outcome with clozapine. Br J Psychiatry 160Suppl 171992 46–53.CrossRefGoogle Scholar
Munetz, MRBenjamin, S.How to examine patient using the Abnormal Involuntary Movement Scale. Hosp Community Psychiatry 1988; 39: 1172–7.Google ScholarPubMed
National Health Insurance Institute of Slovenia. Poslovno porocilo Zavoda za zdravstveno zavarovanje Slovenije za leto 1996. Ljubljana: National Health Insurance Institute of Slovenia; 1997.Google Scholar
O'Boyle, CMcGee, HHickey, AO'Malley, KJoyce, C.Individual quality of life in patients undergoing hip replacement. Lancet 1992; 339: 1088–91.CrossRefGoogle ScholarPubMed
O'Boyle, C.The schedule for the evaluation of individual quality of life. Int J Ment Health 1994; 23: 3–23.CrossRefGoogle Scholar
Pinkney, AAGerber, GJLafave, HG.Quality of life after psychiatric rehabilitation: the clients' perspective. Acta Psychiatr Scand 1991; 83: 86–91.CrossRefGoogle ScholarPubMed
Public Health Institute of Slovenia. Zdravstveni statistični letopis 1996. Zdrav Var 1997; 36 (Suppl 4): 312.Google Scholar
Read, JLQuinn, RJHoefer, MA.Measuring overall health: an evaluation of three important approaches. J Chron Dis 1987; 40: 7–21.CrossRefGoogle ScholarPubMed
Schooler, NRKane, JM.Research diagnoses for tardive dyskinesia. Arch Gen Psychiatry 1982; 39: 486–7.Google ScholarPubMed
Shtasel, PLGur, REGallacher, FHeimberg, CGur, R.Gender differences in the clinical expression of schizophrenia. Schizophr Res 1992; 7: 225–31.CrossRefGoogle ScholarPubMed
Simpson, GMAngus, JWS.A rating scale for extrapyramidal side effects. Acta Psychiatr Scand 12Suppl 441970 11–9.CrossRefGoogle Scholar
Skantze, KMalm, UDencker, SMay, PCorrigan, P.Comparison of quality of life with standard of living in schizophrenic outpatients. Br J Psychiatry 1992; 161: 797–801.CrossRefGoogle Scholar
Statistical Office of the Republic of Slovenia. Statisticni letopis 1997 Volume XXXVI. Ljubljana: Statistical Office of the Republic of Slovenia; 1997.Google Scholar
Tavcar, RDernovsek, MZ.Recidivism in Slovenia. Psychiatr Serv 1997; 48: 955–6.Google ScholarPubMed
Tavcar, RDernovsek, MZZvan, V.Choosing antipsychotic maintenance therapy. A naturalistic study. Pharmacopsychiatry 2000; 33: 66–71.CrossRefGoogle ScholarPubMed
Weiden, PAquila, RStandard, J.Atypical antipsychotic drugs and long-term outcome in schizophrenia. J Clin Psychiatry 1996; 57 (Suppl. 11): 53–60.Google Scholar
Zvan, V.Nacela vzdrzevalne nevrolepticne terapije psihoz. Zdrav Var 1989; 28: 335–41.Google Scholar
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