The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60564

Ann Bagchi, PhD¹, Usha Sambamoorthi, PhD², Elizabeth McSpiritt, MD, MPH³, Philip T. Yanos, PhD², James Walkup, PhD², and Stephen Crystal, PhD². (1) Institute for Health, Health Care Policy and Aging Research, Rutgers University, 30 College Avenue, New Brunswick, NJ 08901, (2) Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Ave, New Brunswick, NJ 08901, (3) Inst. for Health, Health Care Policy, and Aging Research, Division on Aging/AIDS Research Group, Rutgers University, 30 College Avenue, New Brunswick, NJ 08901

Study Design: Merged New Jersey HIV/AIDS surveillance data and paid Medicaid claims were used to analyze use and persistence on antipsychotic medications of individuals with HIV and schizophrenia. Persistence was defined as at least 2 months of medication use in a quarter. Multivariate techniques included simple logistic regressions on use and robust longitudinal regressions that controlled for repeated observations on the same individual and treatment gaps.

Population Studied: We identified 350 individuals who were dually diagnosed with HIV and schizophrenia. Racial/ethnic minorities accounted for the vast majority of beneficiaries in this study, with African Americans representing nearly sixty-five percent of the population and Latinos approximately seventeen percent.

Principal Findings: Overall, 81% of beneficiaries diagnosed with HIV and schizophrenia had at least one claim for an antipsychotic medication at some point between 1992 and 1998. Racial/ethnic minorities were less likely to receive atypical antipsychotic medications. Among users of antipsychotic medications, persistence was very low at 40%. Persistence declined over time and decreased sharply in the first quarter after initiation. Use of atypical antipsychotics was associated with higher persistence.

Conclusions: Our study confirmed past findings on racial disparities in the receipt of atypical antipsychotic medications. Interventions to improve adherence that focus on the period immediately after initiation are needed.

Learning Objectives:

• Objectives of this presentation are both methodological and substantive. At the end of the session, participants will be able to describe the complexity of examining medication adherence using claims data and to understand the differences that exist in patients’ access to pharmaceutical treatment.

Keywords: Adherence, Sever Mental Illness

Presenting author's disclosure statement:
Disclosure not received
Relationship: Not Received.