Project ID NS-MH2024_37

ThemeNS-MH

Co Supervisor 1A Institute of Psychiatry, Psychology & Neuroscience, School of Mental Health & Psychological Sciences, Department of PsychologyWebsite

Co Supervisor 1B Institute of Psychiatry, Psychology & Neuroscience, School of Mental Health & Psychological Sciences, Department of PsychologyWebsite

Using real-world evidence to emulate the cost-effectiveness of different treatment sequences of antipsychotic medication.

Background: The schizophrenia whole disease model (WDM) developed by the applicants is the first health economic model which covers the entire schizophrenia care pathway in the UK, including prevention, diagnosis, and first-line and subsequent lines of treatment. However, due to a lack of RCT assessing different treatment sequences of antipsychotic medication, the effectiveness and safety data of subsequent lines of antipsychotic medications used in the WDM were obtained from network meta-analysis conducted for ‘general’ population with schizophrenia, rather than schizophrenia patients who have failed one or more different antipsychotic medications. To address this limitation, we plan to use the real-world evidence (RWE) included in the Clinical Record Interactive Search (CRIS) to derive the health and cost impacts of different treatment sequences of antipsychotic medications and update the WDM.

Novelty and Importance: To our knowledge, our study will be one of the first studies to use RWE to estimate the health and cost impacts of different antipsychotic sequence in people with schizophrenia. Our findings can help to improve the outcomes for people with schizophrenia by optimising the treatment sequence of antipsychotic medications and minimise the risk/severity of adverse effects.

Primary aim(s): To use the CRIS database to estimate the health and cost impacts of different treatment sequences of antipsychotic medication and use the data to update the schizophrenia WDM.

Training provided: (i) use the CRIS database; (2) use RWE to emulate a clinical trial; and (3) use/adapt the schizophrenia WDM.

Objectives / project plan
Year 1: Background reading, training, and apply access to CRIS.
Year 2: Use the data obtained from the CRIS database to estimate the health and cost impacts of different treatment sequence of antipsychotic medications.
Year 3: Use the derived data to update the schizophrenia WDM.
Year 4: Write up of the thesis and prepare papers for publication.

Representative Publications

Jin, Tappenden, P., MacCabe, J. ., Robinson, S., & Byford, S. (2020). Evaluation of the cost-effectiveness of services for Schizophrenia in the UK across the entire care pathway in a single whole-disease model. https://doi.org/10.1001/jamanetworkopen.2020.5888

Jin, Tappenden, P., MacCabe, J. H., Robinson, S., McCrone, P., & Byford, S. (2021). Cost and health impacts of adherence to the National Institute for Health and Care Excellence schizophrenia guideline recommendations. British Journal of Psychiatry, 218(4), 224–229. https://doi.org/10.1192/bjp.2020.241

Jin, Robinson, S., Shang, W., Achilla, E., Aceituno, D., & Byford, S. (2021). Overview and Use of Tools for Selecting Modelling Techniques in Health Economic Studies. PharmacoEconomics, 39(7), 757–770. https://doi.org/10.1007/s40273-021-01038-1

Byford, Petkova, H., Barrett, B., Ford, T., Nicholls, D., Simic, M., Gowers, S., Macdonald, G., Stuart, R., Livingstone, N., Kelly, G., Kelly, J., Joshi, K., Smith, H., & Eisler, I. (2021). Cost-effectiveness of specialist eating disorders services for children and adolescents with anorexia nervosa: a national surveillance study. Journal of Eating Disorders, 9(1), 1–76. https://doi.org/10.1186/s40337-021-00433-5

Byford, Petkova, H., Stuart, R., Nicholls, D., Simic, M., Ford, T., Macdonald, G., Gowers, S., Roberts, S., Barrett, B., Kelly, J., Kelly, G., Livingstone, N., Joshi, K., Smith, H., & Eisler, I. (2019). Alternative community-based models of care for young people with anorexia nervosa: the CostED national surveillance study. Health Services and Delivery Research, 7(37), 1–78. https://doi.org/10.3310/hsdr07370

Li, Hutchings-Hay, C., Byford, S., & Tchanturia, K. (2022). How to support adults with anorexia nervosa and autism: Qualitative study of clinical pathway case series. Frontiers in Psychiatry, 13, 1016287–1016287. https://doi.org/10.3389/fpsyt.2022.1016287