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Use of mediation analysis to evaluate the role of adherence on the comparative effects of atypical antipsychotics in schizophrenia

Posted on:2017-12-11Degree:Ph.DType:Dissertation
University:Thomas Jefferson UniversityCandidate:Fastenau, John MichaelFull Text:PDF
GTID:1456390005480679Subject:Mental Health
Abstract/Summary:
Schizophrenia is a serious mental illness requiring lifelong treatment and antipsychotics are used to alleviate debilitating symptoms. Increasingly, payers are implementing formulary controls affecting access to these essential medications, though other barriers to use exist. While the comparative effects of antipsychotics have been assessed, findings from recently published meta-analyses and other study methodologies are inconsistent. Some suggested a benefit, others not, for long-acting injectable (LAI) over oral antipsychotics. The primary objective of this research was to measure the indirect effects of LAI and oral atypical antipsychotics on hospital re-admission, mediated through an adherence causal pathway. Mediation is an analytical approach to understand causal pathways and address important research questions regarding how interventions may transmit effects on outcomes. The use of mediation analysis for comparative effectiveness research (CER) is underutilized. (Abstract shortened by ProQuest.).
Keywords/Search Tags:Antipsychotics, Effects, Mediation, Comparative
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