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The authors used data from San Diego County Adult Mental Health Services to identify individuals who were diagnosed with schizophrenia by a specialty mental health provider and who were living in the community during fiscal years 1999 and 2000.
These data were merged with 3 years of data from Medi-Cal eligibility and claims (1998-2000) and identified fee-for-service beneficiaries continuously enrolled over the course of a year who filled at least 1 prescription for an antipsychotic medication.
- This analysis was based on prescription fills for oral antipsychotic medications.
Adherence to prescribed regimens was determined by examining Medi-Cal claims by means of medication refill records. Adherence was measured by the annual cumulative possession ratio, which was computed for each person in each calendar year. The cumulative possession ratio was calculated by dividing the number of days medications were available for consumption by the number of days participants were eligible for Medi-Cal.
A person-year’s adherence was derived from the cumulative possession ratio using the following designations: non-adherent (ratio=0.00-0.49), partially adherent (ratio=0.50-0.79), adherent (ratio=0.80-1.10), and excess medication fillers (ratio >1.10).
24% of patients were considered nonadherent, 16% were partially adherent, 19% were excess fillers, and 41% were adherent.
Reference:
Gilmer TP, Dolder CR, Lacro JP, et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry. 2004; 161(4): 692-699.