A real-world data analysis of electronic health records to investigate the associations of predominant negative symptoms with healthcare resource utilisation, costs and treatment patterns among patients with schizophrenia

ObjectivesNegative symptoms in schizophrenia are associated with significant illness burden. We sought to investigate clinical outcomes for patients with schizophrenia who present with predominant negative symptoms (PNS) vs without PNS.DesignRetrospective analysis of electronic health record (EHR) d...

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Bibliographic Details
Published in:BMJ open 2024-07, Vol.14 (7), p.e084613
Main Authors: Patel, Rashmi, Dembek, Carole, Won, Yida, Kadakia, Aditi, Huang, Xueyan, Zeni, Courtney, Pikalov, Andrei
Format: Article
Language:English
Subjects:
Adult
Antipsychotic Agents - economics
Antipsychotic Agents - therapeutic use
Antipsychotics
Clinical outcomes
Comorbidity
Datasets
Demographics
Electronic Health Records
Female
Hallucinations
Health Care Costs - statistics & numerical data
Health care expenditures
hospitalization
Hospitalization - economics
Hospitalization - statistics & numerical data
Humans
Male
Mental disorders
Mental Health
Middle Aged
Natural language processing
Original Research
Patient Acceptance of Health Care - statistics & numerical data
Patients
Psychotropic drugs
Retrospective Studies
Schizophrenia
schizophrenia & psychotic disorders
Schizophrenia - economics
Schizophrenia - therapy
United States - epidemiology
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Summary:ObjectivesNegative symptoms in schizophrenia are associated with significant illness burden. We sought to investigate clinical outcomes for patients with schizophrenia who present with predominant negative symptoms (PNS) vs without PNS.DesignRetrospective analysis of electronic health record (EHR) data.Setting25 US providers of mental healthcare.Participants4444 adults with schizophrenia receiving care between 1999 and 2020.ExposurePNS defined as ≥3 negative symptoms and ≤3 positive symptoms recorded in EHR data at the time of the first recorded schizophrenia diagnosis (index date). Symptom data were ascertained using natural language processing applied to semistructured free text records documenting the mental state examination. A matched sample (1:1) of patients without PNS was used to compare outcomes. Follow-up data were obtained up to 12 months following the index date.Primary outcome measureMean number of psychiatric hospital admissions.Secondary outcome measuresMean number of outpatient visits, estimated treatment costs, Clinical Global Impression – Severity score and antipsychotic treatments (12 months before and after index date).Results360 (8%) patients had PNS and 4084 (92%) did not have PNS. Patients with PNS were younger (36.4 vs 39.7 years, p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2024-084613