Geographic Access to Community Mental Healthcare and Adherence to Treatment Among Patients with Schizophrenia Spectrum Disorders.

Smith-East, Marie; Neff, Donna Felber; Hawthorne, Timothy; Conner, Norma E.; Edwards, Joellen

Non-adherence to antipsychotic medications is a commonly recognized problem that can lead to lack of follow-up for patients with schizophrenia spectrum disorders, increasing risk for psychotic symptoms, hospitalizations, and decreased quality of life. We conducted a secondary data analysis of electronic health record data of patients with schizophrenia spectrum disorders (n = 1,341) in Central Florida to explore relationships between geographic access to mental healthcare facilities, socioeconomic factors, and follow-up visits, and whether these conditions contributed to adherence over 1 years' time. Using Geographic Information Systems among six mental health facilities, spatial analysis and logistic regression indicated that patients had 27.9% increased odds (p = 0.02) of adherence to treatment when travel time to facilities was 30 min or less. Spatial autocorrelation revealed significant positive clusters in areas with low travel time (15 min or less). Patients who had Medicaid, a case manager and/or a life skills coach, medication side effects, a substance use disorders history, and/or closer proximity to mental healthcare services, had an increased likelihood of attending four or more follow-up visits in 1 year. Identifying effects of spatial and non-spatial variables on non-adherence to treatment can provide useful insights for developing targeted interventions to improve treatment outcomes.

UNITED States; DRUG therapy for schizophrenia; COMPETENCY assessment (Law); HEALTH services accessibility; PATIENT compliance; RESEARCH funding; SECONDARY analysis; DRUG side effects; AUTISM; LOGISTIC regression analysis; HOSPITAL care; POPULATION geography; TREATMENT effectiveness; DESCRIPTIVE statistics; CHI-squared test; LONGITUDINAL method; GEOGRAPHIC information systems; MEDICAL records; ACQUISITION of data; QUALITY of life; ASPERGER'S syndrome; SOCIODEMOGRAPHIC factors; DRUGS; MEDICAID; HEALTH facilities; HEALTH outcome assessment; COMPARATIVE studies; DATA analysis software; PEOPLE with disabilities; PSYCHIATRIC drugs; ADULTS

Issues in Mental Health Nursing, 2024, Vol 45, Issue 12, p1319

0161-2840

Academic Journal

10.1080/01612840.2024.2408579