Objective: Examine impact of participant factors on time to switch from first- to second- generation agents among participants in the Schizophrenia Care and Assessment Project (SCAP). Methods: Baseline data identified participants not receiving novel agents (n=520). Accelerated failure time (AFT) (Weibull distribution error) applied. Years between disease onset and study initiation included. Dependent variable: days between study initiation and first switch to second-generation. Right censoring addressed (dichotomous censor: 1=switch during window). Results: One-fourth (n=133) experienced switch (mean time=171.08 days). Hypothesis: persons with higher side effect and symptom scores exhibit shorter time to switch. Persons with higher side effect scores (AIMS) experienced longer interval (1.08; p=0.01) and those with higher depression scores (MADRS) experienced shorter time to switch (0.97; p=0.02). Those receiving service through university hospital experienced longer interval (3.19; p=0.01). The computed hazard rate (-0.68) indicates the risk of switch is decreasing over time. Conclusions: Symptoms and type of service site drive switch from older to newer agents. The shorter interval for those with higher depression scores is expected and may indicate clinical intervention toward the amelioration of negative symptoms. The longer interval for those with higher side effect scores was contrary to expectation and may indicate that change is related to primary disease presentation, rather than reduction of secondary symptoms. The longer interval for those receiving care in a university hospital setting is perplexing since it is expected that medication adjustment will occur during hospital stays. Further investigation may be aided by the inclusion of physician level information, anticipated in upcoming analyses.
Learning Objectives: Attendees will be able to identify factors impacting the switch from first to second generation agents.
Keywords: Mental Health, Drugs
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.