3 years ago

Increasing medication adherence and income assistance access for first-episode psychosis patients

Mark Smith, Dan Chateau, Marni Brownell, Jennifer Enns, Elaine Burland, Nathan C. Nickel, the PATHS Equity Team, Alan Katz, James M. Bolton, Jason Randall, Carole Taylor, Laurence Katz

by Jason Randall, Dan Chateau, James M. Bolton, Mark Smith, Laurence Katz, Elaine Burland, Carole Taylor, Nathan C. Nickel, Jennifer Enns, Alan Katz, Marni Brownell, the PATHS Equity Team

Background

Assertive community treatment for first-episode psychosis programs have been shown to improve symptoms and reduce service use. There is little or no evidence on whether these programs can increase access to income assistance and improve medication adherence in first episode psychosis patients. This research examines the impact of the Early Psychosis Prevention and Intervention Service (EPPIS) on these outcomes.

Methods

We extracted data on EPPIS patients held in the Data Repository at the Manitoba Centre for Health Policy. The Repository is a comprehensive collection of person-level de-identified administrative records, including data from Manitoba’s health services. We compared income assistance use and antipsychotic medication adherence in EPPIS patients to a historical cohort matched on pattern of diagnosis. Confounders were adjusted through propensity-score weighting with asymmetrical trimming. Odds ratios (OR), hazard ratios (HR) and 95% confidence intervals were calculated.

Results

We identified a matched sample of 244 patients and 449 controls. EPPIS patients had a higher rate of income assistance use during the program (67·4% vs. 38·7%; p< 0·0001). EPPIS patients were more likely to have been prescribed at least one antipsychotic medication than the control cohort, both during the program (OR = 15·05; 95%CI 10·81 to 20·94) and after the program ended (OR = 5·20; 95%CI: 4·50 to 6·02). Patients in EPPIS were also more likely to adhere to their medication during the program (OR = 4·71; 95%CI 3·75 to 5·92), and after the program (OR = 2·54; 95%CI 2·04 to 3·16).

Conclusion

Enrolment in the EPPIS program was associated with increased adherence to antipsychotic medication treatment and improved uptake of income assistance.

Publisher URL: http://journals.plos.org/plosone/article

DOI: 10.1371/journal.pone.0179089

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