Adherence to common cardiovascular medications in patients with schizophrenia vs. patients without psychiatric illness
Owen-Smith A, Stewart C, Green C, Ahmedani B, Waitzfelder B, Rossom R, Copeland L, Simon G. Adherence to common cardiovascular medications in patients with schizophrenia vs. patients without psychiatric illness. General Hospital Psychiatry 2016; 38:9-14.
General Hospital Psychiatry
OBJECTIVE: The purpose of the study was to examine whether individuals with diagnoses of schizophrenia were differentially adherent to their statin or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) medications compared to individuals without psychiatric illness.
METHOD: Using electronic medical record data across 13 Mental Health Research Network sites, individuals with diagnoses of schizophrenia or schizoaffective disorder receiving two or more medication dispensings of a statin or an ACEI/ARB in 2011 (N=710) were identified and matched on age, sex and Medicare status to controls with no documented mental illness and two or more medication dispensings of a statin in 2011 (N=710). Medication adherence, and sociodemographic and clinical characteristics of the study population were assessed.
RESULTS: Multivariable models indicated that having a schizophrenia diagnosis was associated with increased odds of statin medication adherence; the odds ratio suggested a small effect. After adjustment for medication regimen, schizophrenia no longer showed an association with statin adherence. Having a schizophrenia diagnosis was not associated with ACEI/ARB medication adherence.
CONCLUSIONS: Compared to patients without any psychiatric illness, individuals with schizophrenia were marginally more likely to be adherent to their statin medications. Given that patterns of adherence to cardioprotective medications may be different from patterns of adherence to antipsychotic medications, improving adherence to the former may require unique intervention strategies.
Medical Subject Headings
Aged; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Cardiovascular Diseases; Case-Control Studies; Comorbidity; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Medication Adherence; Middle Aged; Multivariate Analysis; Odds Ratio; Psychotic Disorders; Schizophrenia; United States