Continuity of Medication Management among Adults with Schizophrenia and Comorbid Cardiometabolic Conditions.
OBJECTIVES: Adults with schizophrenia and cardiometabolic conditions may be good candidates for co-management by primary care prescribers and specialists. Associated risks for discontinuity in medication management have not been well-studied. This study examines whether medication adherence, inpatient admissions, and emergency department (ED) visits vary by the number and types of prescribers seen by adults with schizophrenia and cardiometabolic conditions. METHODS: This study used a retrospective cohort of 4,223 adult Medicaid enrollees with schizophrenia and hypertension, hyperlipidemia, and/or diabetes from three states in 2009-2010. Logistic regression models were run on outcome variables reflecting medication adherence, ED utilization, and inpatient admissions as a function of the number and types of prescribers. KEY FINDINGS: Increases in number of psychiatric specialists were associated with better antipsychotic adherence, but decreasing statin adherence. Increases in number of psychiatric specialists were also associated with a higher probability of inpatient admission and ED visits, while increases in number of primary care prescribers were associated with increases in the probability of ED visits. CONCLUSION: Greater antipsychotic adherence for adults receiving prescriptions from multiple psychiatric specialists was counteracted by lower statin adherence and greater risk of ED and inpatient utilization. This may help inform optimal care models for these complex individuals.
Duke Scholars
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- 4203 Health services and systems
- 3214 Pharmacology and pharmaceutical sciences
- 1117 Public Health and Health Services
- 1115 Pharmacology and Pharmaceutical Sciences
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Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- 4203 Health services and systems
- 3214 Pharmacology and pharmaceutical sciences
- 1117 Public Health and Health Services
- 1115 Pharmacology and Pharmaceutical Sciences