Results Summary and Professional Abstract
|Article Highlight: This study reviewed how different drug combinations work for people with schizophrenia, who often take several medications to treat different symptoms of their disease. Through a review of 81,921 Medicaid records, the researchers found that people already taking an antipsychotic drug had different benefits and negative outcomes when they used another antipsychotic or added an antidepressant, anti-anxiety medication or mood stabilizer. These results, in JAMA Psychiatry, can help people with schizophrenia and their doctors when they consider adding medicines to patients’ treatment plans.|
|This project's final research report is expected to be available by December 2019.|
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:
- Reviewers asked if the individuals analyzed in this study had been required to stay on their original antipsychotic medication. The researchers responded that patients were not necessarily required to continue the first antipsychotic after the patients started a new psychotropic medication. However, patients had an active supply of antipsychotic medication when starting the new medication. For instance, if patients started a new antipsychotic medication, this could indicate a switch between two similar medications or an addition to their treatment regimen.
- Reviewers noted, based on Figure 2, that psychotropic polypharmacy led to the exclusion of a large number of patients from the study and that this could effect the generalizability of findings. The researchers agreed. They added a comment to the discussion that because this polypharmacy is so common, it is an important topic to consider in future research.
- Reviewers noted that the report mentioned surveying clinicians about treatment choices and suggested that surveying patients could have helped determine which outcomes matter most to them. The researchers responded that they had conducted a small survey with clinicians when applying for funding. They acknowledged that patients would find other outcomes important as well, but also stated that patients saw hospitalizations, emergency department visits, and deaths as important outcomes.
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Individuals with Multiple Chronic/co-morbid Conditions