OBJECTIVES: To examine the influence of cognitive impairment on functioning, medical resource utilization, adherence, and health-related quality of life (HRQoL) in patients with schizophrenia. METHODS: Data analyzed were from a cross-sectional study of patients with schizophrenia and their physicians (2005 Adelphi US Psychoses XI Disease Specific Programme). Outpatient schizophrenia patients aged >18 years with >4 physician encounters in the past 12 months were identified. Physicians evaluated their patients' cognitive impairment, positive and negative symptoms, functioning(employment status, presence ofa caregiver, global assessment of functioning (GAF) scale, Likert scales measuring overall function and ability to meet own basic needs), adherence, and resource utilization. HRQoL (EQ-5D tariff and visual analog scale (VAS), Likert scales measuring overall sense of well being, overall life satisfaction, and satisfaction with relationships) and adherence data were collected directly from patients. Multivariate analyses were used to examine the predictors for each outcome variable. Covariates included patients' demographics and their comorbidities. RESULTS: Eighty one percent of the 839 schizophrenia patients had cognitive impairment. A higher level ofcognitive function was associated with higher overall functioning and GAF scores, improved ability to meet basic needs, being employed, not having a caregiver, fewer ER visits, greater medication adherence, better HRQoL (EQ-5D and VAS scores), overall sense of well-being, and higher satisfaction with life and social relationships (p<0.05). The severity of positive and negative symptoms was positively associated with poorer functioning, number ofoutpatient visits, and poorer HRQoL. Severe positive symptoms also predicted more hospitalizations and poorer adherence (p<0.05). Cognitive impairment was associated with fourteen outcomes, while positive and negative symptoms predicted nine and six outcomes respectively. CONCLUSIONS: Cognitive impairment in schizophrenia patients is significantly associated with a number of measures of disease burden, which can substantially increase the impact of the disease beyond that associated with only positive and negative symptoms.
Lin, F. J., Bhor, M., Hass, S., Perry, R., & Kay, S. (2011). PMH18 IMPACT OF COGNITIVE IMPAIRMENT ON FUNCTIONING, MEDICAL RESOURCE UTILIZATION, ADHERENCE AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH SCHIZOPHRENIA. Value in Health, 14(3), A188. https://doi.org/10.1016/j.jval.2011.02.1042