조현병을 처음 진단받은 환자들의 초기 투약 순응도에 따른 발병 1년 후 임상 결과: 국민건강보험공단 자료에 기반한 후향적 코호트 연구 (One-Year Clinical Outcomes After Diagnosis According to Early Medication Adherence in First-Episode Schizophrenia: A Nationwide, Health Insurance Data-Based Retrospective Cohort Study)

서지정보

· 발행기관 : 대한조현병학회
· 수록지 정보 : 대한조현병학회지 / 26권 / 1호 / 24 ~ 31페이지
· 저자명 : 최우혁, 주성우, 안수진, 최영재, 김선민, 이중선

초록

Objectives: Early pharmacologic intervention is considered necessary for improving the prognosis in patients with first-episode schizophrenia (FES). However, few nationwide population-based studies have focused on early medication adherence. We in- vestigated the status of early adherence to antipsychotics and the effect of early adherence on later clinical outcomes in FES. Methods: We used data from the South Korean Health Insurance Review Agency database (2009-2021). We selected 28,931 pa- tients with FES who had a prescription record of at least one antipsychotic medication within 180 days after their diagnosis. We measured early medication adherence using the medication possession ratio (MPR) and compared demographic characteristics and results of psychiatric hospitalization between the adherence group (0.6≤MPR<1.1) and the non-adherence group (MPR<0.6). Results: The average early medication adherence was 0.82 by MPR, and the non-adherence group accounted for 15.6% of all subjects. From 1 to 2 years after diagnosis, the adherence group showed a higher number of psychiatric hospitalizations per hos- pitalized patient but a shorter duration than the non-adherence group. Additionally, the proportion of patients who experienced psychiatric hospitalizations was smaller in the adherence group.
Conclusion: In patients with FES, early medication adherence is associated with lower rates of psychiatric hospitalization and shorter hospitalization durations.

영어초록

Objectives: Early pharmacologic intervention is considered necessary for improving the prognosis in patients with first-episode schizophrenia (FES). However, few nationwide population-based studies have focused on early medication adherence. We in- vestigated the status of early adherence to antipsychotics and the effect of early adherence on later clinical outcomes in FES. Methods: We used data from the South Korean Health Insurance Review Agency database (2009-2021). We selected 28,931 pa- tients with FES who had a prescription record of at least one antipsychotic medication within 180 days after their diagnosis. We measured early medication adherence using the medication possession ratio (MPR) and compared demographic characteristics and results of psychiatric hospitalization between the adherence group (0.6≤MPR<1.1) and the non-adherence group (MPR<0.6). Results: The average early medication adherence was 0.82 by MPR, and the non-adherence group accounted for 15.6% of all subjects. From 1 to 2 years after diagnosis, the adherence group showed a higher number of psychiatric hospitalizations per hos- pitalized patient but a shorter duration than the non-adherence group. Additionally, the proportion of patients who experienced psychiatric hospitalizations was smaller in the adherence group.
Conclusion: In patients with FES, early medication adherence is associated with lower rates of psychiatric hospitalization and shorter hospitalization durations.

참고자료

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