• Lizheng Shi, Yingnan Zhao, Vivian Fonseca, Haya Ascher-Svanum, Yi-Ju Chiang, and Daniel Winstead.
• Tulane University and Southeast Louisiana Veterans Health Care System, New Orleans, LA 70112, USA. lshi1@tulane.edu
• Curr Med Res Opin. 2010 Oct 1; 26 (10): 249925062499-506.

ObjectiveTo assess the association between pre-existing metabolic syndrome and health outcomes among veterans with schizophrenia.MethodsThe Veterans Integrated Service Network 16 data (VISN16) for 10/2002 - 08/2005 were used to identify patients (n = 593) with schizophrenia (ICD-9 codes: 250.xx) who were switched to a new antipsychotic agent in response to metabolic monitoring as part of a VISN 16 metabolic monitoring program. Two groups (patients with pre-existing metabolic syndrome [MetSyn+] and without [MetSyn-]) were compared on resource utilization, antipsychotic adherence (medication possession ratio: MPR) and persistence (time to all-cause discontinuation of the switched antipsychotic) over 1 year.ResultsAbout one-third of the patients who have undergone metabolic monitoring before the medication switch (35.2%) had metabolic syndrome. The two groups did not significantly differ on healthcare resource utilization, MPR, or time to all-cause medication discontinuation. Adherence and persistence levels were relatively poor for both groups (mean MPR = 0.33 for MetSyn+; MPR = 0.38 for MetSyn-). The median time to all-cause medication discontinuation was 50 days for both groups.ConclusionsIn this retrospective study of patients with schizophrenia, the presence of pre-existing metabolic syndrome did not appear to impact patients' healthcare resource utilization or their adherence and persistence with antipsychotic medication.

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