(#108) A Qualitative, Interview-based Study of Patient, Caregiver, And Prescriber Rankings of Functional Outcome Improvements in Schizophrenia

Abstract: Functional impairment in schizophrenia results in substantial burden to patients, caregivers, and healthcare systems. Addressing this impairment remains a critical unmet need in treatment. To better characterize the relative importance of various functional outcomes (FOs), qualitative interviews and ranking (top-5) and rating (0=not important to 3=very important) exercises were conducted with patients (n=10), caregivers (n=12), and prescribers (n=5) in the US. Selection of 26 FO concepts across 4 domains: 1) Activities of Daily living (ADL); 2) Self-care/Appearance/Health; 3) Relationships/Communication; 4) Social/Leisure, was informed by literature and existing instruments. Eligible participants included patients who were 18-65 years old, diagnosed with schizophrenia for ≥ 1 year; caregivers who provided ≥ 20 hours/week of care for ≥ 1 year; and prescribers who were board-certified psychiatrists treating/managing ≥ 10 adults with schizophrenia/month. Mean ages of patients and caregivers were 45.5 and 58.2 years, respectively. On average, patients were diagnosed 14.8 years prior, caregivers provided care for 14.3 years, and prescribers practiced for 11.4 years and treated 31 patients/month. For patients, ADL was the highest ranked domain with "doing chores" and "maintaining a job" ranked in the top-5 by 60% and 40% of patients, respectively, and with assigned mean importance ratings of 2.2 (SD=1.1) and 2.0 (SD=1.2), respectively. For caregivers and prescribers, Self-care/Appearance/Health was the highest ranked domain with "medication adherence", "attending appointments", and "personal hygiene" ; mean importance ratings for caregivers was 2.8 [SD=0.9] for all three concepts and for prescribers, mean = 3.0 [SD=0], 3.0 [SD=0], 2.8 [SD=0.4], respectively.

Short Description: In this qualitative study, caregivers and prescribers prioritized functional outcome (FO) concepts in the Self-care, Appearance, and Health domain, specifically "medication adherence", "attending appointments", and "personal hygiene." Conversely, patients prioritized FO concepts in the ADL domain, specifically "doing chores" and "maintaining a job." This data highlights potential differences in FO priorities by varying stakeholders; further research should explore implications of these differences in clinical care delivery and development of novel therapies for schizophrenia.

Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc