Open access Non-adherence to antipsychotic medication regimens: associations with resource use and costs

Martin Knapp, Derek King, Klaus Pugner, Pablo Lapuerta (2004)

Please note: this is a legacy publication from CPEC (formely PSSRU at LSE).

British Journal of Psychiatry 184 6 509-516

https://doi.org/10.1192/bjp.184.6.509

http://bjp.rcpsych.org/cgi/content/full/184/6/509

Abstract
Background Several factors are thought to influence resource use and costs in treating schizophrenia. Aims To assess the relative impact of non-adherence and other factors associated with resource use and costs incurred by people with schizophrenia. Method Secondary analyses were made of data from a 1994 national survey of psychiatric morbidity among adults living in institutions in the UK. Factors potentially relating to resource use and costs were examined using two-part models. Results Patients who failed to adhere to their medication regimen were over one-and-a-half times as likely as patients who did adhere to it to report use of in-patient services. Non-adherence is one of the most significant factors in increasing external service costs, by a factor of almost 3. Non-adherence predicted an excess annual cost per patient of approximately £2500 for in-patient services and over £5000 for total service use. Conclusions Resource use and costs are influenced by various factors. Medication non-adherence consistently exhibits an association with higher costs. Further important factors are patient needs and the ability of the system to address them.