3215.0: Monday, November 13, 2000 - Board 8

Abstract #3361

Preferences for schizophrenia outcomes: Stakeholder group differences

Martha Shumway, PhD, Psychiatry Department, University of California, San Francisco, 1001 Potrero Ave, Rm 7M-W21, San Francisco, CA 94110, 415-206-5577, shumway@itsa.ucsf.edu

BACKGROUND: Schizophrenia is a complex illness requiring complex treatments. Treatment comparisons require indices that account for the relative importance of schizophrenia's multiple outcomes as well as differences in perspective among stakeholder groups involved in treatment. GOALS: This study quantified preferences for key schizophrenia outcomes in four stakeholder groups and tested the hypotheses that outcome domains differ in importance and stakeholder groups have different preferences. METHODS: Fifty persons with schizophrenia, 39 family members of persons with schizophrenia, 50 clinicians and 50 members of the general public rated 16 descriptions of health states associated with schizophrenia. These ratings yielded "importance weights" for seven outcomes: psychotic symptoms, deficit symptoms, extrapyramidal syndrome, tardive dyskinesia, social functioning, vocational functioning and independent living. RESULTS: Outcome domains differed in importance (F=23.4, p<.01). All stakeholders rated psychotic symptoms (mean importance weight=15.9) and social functioning (mean=18.9) as more important than negative symptoms (mean=10.1) and extrapyramidal syndrome (mean=10.2). Stakeholder groups had different outcome preferences (F=1.9, p=.01). Persons with schizophrenia rated extrapyramidal syndrome as more important than others (p<.01); clinicians rated social functioning as more important than persons with schizophrenia and their families (p<.05); and clinicians and family members rated vocational functioning as more important than persons with schizophrenia and the general public (P<.05). CONCLUSIONS/IMPLICATIONS: Results show that schizophrenia treatment outcomes are not equally important and that stakeholder groups value outcomes differently. The study produced importance weights for seven outcome domains that can be used in cost-utility analyses to clarify the relative effectiveness of alternative treatments.

Learning Objectives: Participants will learn about: 1. The need to quantify preferences for treatment outcomes for cost effectiveness and cost -utility analysis. 2. The relative importance of key schizophrenia outcomes. 3. Stakeholder group differences in preferences for schizophrenia outcomes. 4. The application of stakeholder preferences in treatment comparisons

Keywords: Mental Disorders, Cost Issues

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA