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. 2018 Sep 12;18(1):292.
doi: 10.1186/s12888-018-1856-y.

Patient Preferences Concerning the Efficacy and Side-Effect Profile of Schizophrenia Medications: A Survey of Patients Living With Schizophrenia

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Free PMC article

Patient Preferences Concerning the Efficacy and Side-Effect Profile of Schizophrenia Medications: A Survey of Patients Living With Schizophrenia

Eric Achtyes et al. BMC Psychiatry. .
Free PMC article

Abstract

Background: Despite the availability of numerous antipsychotic medications, many patients with schizophrenia continue to experience side effects that contribute to the overall burden of the illness. The present survey of patients with schizophrenia and schizoaffective disorder aimed to assess patient attitudes toward antipsychotic treatment, and understand key factors about willingness to try a new medication.

Methods: A cross-sectional survey was administered to 250 patients with a primary clinical diagnosis of a schizophrenia spectrum disorder across five outpatient clinics in the United States. The survey included self-reported gender, age, weight, and height, and questions about the importance of efficacy and side effects on the decision to take a prescribed antipsychotic medication.

Results: Patients rated efficacy and side effects as important attributes of antipsychotic treatment, with 93.6% and 83.6% of patients listing these as "very" or the "most" important factors in taking prescribed medication. A total of 87.6% of respondents identified the ability to think more clearly as an important property of their medication. Patients identified weight gain, physical restlessness, and somnolence as important side effects of current treatments ("very" or "most" important by 61.6%, 60.8%, and 58.8%, respectively). When asked about willingness to change antipsychotic medication, anticipated weight gain had a negative influence on willingness to try the new treatment, with 22.0% declining to try a medication that would lead to weight gain of 2.7-4.5 kg (6-10 lb), 34.0% declining for anticipated weight gain of 5.0-9.1 kg (11-20 lb), and 52.4% declining for anticipated weight gain greater than 9 kg (20 lbs).

Conclusion: Patients living with schizophrenia spectrum disorders are influenced by many factors when considering whether to take their medication, including efficacy and side effects. It is important for clinicians to assess specific patient concerns to develop a comprehensive treatment plan that maximizes adherence to the prescribed therapy.

Keywords: Adherence; Antipsychotics; Side effects; Weight.

Conflict of interest statement

Ethics approval and consent to participate

This survey was approved by the Northwell Health Institutional Review Board. Patients were given an information sheet describing the study and verbal informed consent was obtained from patients who agreed to complete the survey.

Consent for publication

Not applicable

Competing interests

EA (MD), has received research support from Alkermes, AssurEx, Avanir, Boehringer Ingelheim, Janssen, Neurocrine Biosciences, Novartis, Otsuka, Pfizer, Pine Rest Foundation, Priority Health, Network180, and Vanguard Research Group and has served on advisory panels for Roche, Janssen, Neurocrine Biosciences and the Vanguard Research Group. PM is the executive director of the Vanguard Research Group, which has received research support from Otsuka, Alkermes, Lundbeck, and Janssen. PJW (MD), A Simmons (MPH), NL, and YJ (PhD), are employees of Alkermes, Inc. A Skabeev (MD), was employed by Alkermes at the time of the study.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Importance of common side effects of schizophrenia treatments by gender*. Source: Survey Question 2. Many current treatments for schizophrenia have side effects. How important are these side effects to you? *Data not included for patients who did not self-report gender (n = 4)
Fig. 2
Fig. 2
Influence of anticipated weight gain on patient’s decision to take medicine*. *The number (percentage) of patients with missing responses in each weight gain category are: less than 2 kg, n = 2 (0.8%); 3–5 kg, n = 2 (0.8%); 5–9 kg, n = 1 (0.4%). Source: Survey Question 3. One side effect of many medicines for schizophrenia is weight gain. How much would gaining weight influence your decision to take a medicine?
Fig. 3
Fig. 3
Patients who would not take a medication or who said their decision would be greatly influenced by the anticipated range of weight gain (by gender)*,†. *Data not included for patients who did not self-report gender (n = 4). 210 patients (84%) surveyed had responses that did not change or increased across increasing categories of weight gain. 40 (16%) surveyed had inconsistent responses across weight gain categories. Source: Survey Question 3. One side effect of many medicines for schizophrenia is weight gain. How much would gaining weight influence your decision to take a medicine?

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