{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T16:10:11Z","timestamp":1761063011528,"version":"build-2065373602"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,10,2]],"date-time":"2012-10-02T00:00:00Z","timestamp":1349136000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:sec><jats:title>Study Objective<\/jats:title><jats:p>To compare the performance of various compliance and persistence measures in predicting schizophrenia\u2010related hospitalization rates and inpatient costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective, nonrandomized cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p>Prescription claims databases from three German sickness funds (public health insurance programs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 1484 patients who were hospitalized in 2003 for a schizophrenia\u2010related episode and subsequently received long\u2010term antipsychotic pharmacotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>Data on age, sex, schizophrenia, prescription drugs, hospitalizations, and inpatient expenditures were collected for each patient from the three <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>erman sickness funds. Refill compliance measures based on single\u2010interval availability and multiple\u2010interval availability, as well as refill persistence, were calculated for each patient over 1\u00a0year. Ten measurement variables were compared with respect to their performance in predicting disease\u2010related hospitalization and inpatient expenditure, using multivariate logistic regression and gamma regression, respectively. <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u2010statistics were calculated to determine each measure's predictive performance. Likelihood ratio tests showed that inclusion of compliance and persistence measures significantly improved (p&lt;0.05) outcomes prediction in 6 of 10 hospitalization models and in 3 of 10 inpatient cost models compared with a baseline model that included only age, sex, and disease severity covariates. Refill compliance as a continuous variable of drug persistence, including transfer of oversupplies into subsequent periods, performed best in predicting hospitalization (<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u00a0=\u00a00.669). Availability ratios, capped at 100%, were superior to default availability ratios in predicting hospitalization. Allowing for cross\u2010period carryover improved the discriminatory performance of the persistence models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Refill persistence measures appear sufficiently flexible to account for hospitalizations common in schizophrenia and other psychiatric diseases. A continuous refill persistence measure should be used to assess compliance in psychiatric conditions when working with administrative data.<\/jats:p><\/jats:sec>","DOI":"10.1002\/j.1875-9114.2012.01120","type":"journal-article","created":{"date-parts":[[2012,10,2]],"date-time":"2012-10-02T09:50:00Z","timestamp":1349171400000},"page":"880-889","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Performance of Compliance and Persistence Measures in Predicting Clinical and Economic Outcomes Using Administrative Data from German Sickness Funds"],"prefix":"10.1002","volume":"32","author":[{"given":"Simon","family":"Frey","sequence":"first","affiliation":[{"name":"Hamburg Center for Health Economics University of Hamburg Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Stargardt","sequence":"additional","affiliation":[{"name":"Hamburg Center for Health Economics University of 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