Adherence to common cardiovascular medications in patients with schizophrenia vs. patients without psychiatric illness

Gen Hosp Psychiatry. Jan-Feb 2016;38:9-14. doi: 10.1016/j.genhosppsych.2015.07.010. Epub 2015 Jul 30.

Abstract

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.

Keywords: Cardiovascular medications; Medication adherence; Schizophrenia; Serious mental illness.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / epidemiology*
  • Case-Control Studies
  • Comorbidity
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Psychotic Disorders / epidemiology*
  • Schizophrenia / epidemiology*
  • United States / epidemiology

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors