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Overcoming Patient Access Barriers in Complex Conditions: Lessons from Schizophrenia for Broader Healthcare Applications
Saartje Burgmans, Anne Rieper Hald, Sayagi Tina Markandaier, N. M. Hall, Rafael Loiseau, Xandra Lie, Bregt S Kappelhoff. Journal of Market Access & Health Policy, 2025-12-23
Topic: Risk, prevention and care in population studies
Patient access to innovative care for complex conditions like schizophrenia remains limited by systemic, clinical and policy-level barriers. Cognitive impairment associated with schizophrenia (CIAS) illustrates how critical symptom domains are often overlooked despite their impact on long-term outcomes. This study examines how systemic, infrastructural and economic factors shape access to CIAS care across eight mid-sized European countries to identify shared constraints and opportunities for improvement. Semi-structured interviews were conducted with 32 healthcare professionals and 9 health policy experts. Thematic analysis identified consistent barriers across countries, including fragmented care pathways, insufficient capacity for cognitive assessment, underdeveloped community-based rehabilitation services and reimbursement structures that favour pharmacological over psychosocial interventions. Variability across countries was shaped by differences in community infrastructure, professional training and the breadth of health technology assessment perspectives applied to non-pharmacological care. Countries with stronger community infrastructure and broader reimbursement frameworks were better positioned to deliver comprehensive care. These findings highlight that structural constraints, rather than clinical uncertainty, are the primary impediments to care in complex therapeutic areas. Addressing them will require coordinated reforms that strengthen early identification, expand multidisciplinary rehabilitation capacity and align reimbursement with functional and long-term outcomes.
Key findings
- Cognitive impairment associated with schizophrenia (CIAS) illustrates how critical symptom domains are often overlooked despite their impact on long-term outcomes.
- These findings highlight that structural constraints, rather than clinical uncertainty, are the primary impediments to care in complex therapeutic areas.
Why it matters
This study examined barriers to care for cognitive impairment in schizophrenia across European countries and found that structural issues like fragmented care and limited reimbursement are the main obstacles. It does not address Alzheimer's disease treatment, cure, or prevention.
Study details
- Evidence strengthLow
How this study scored 30/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Market Access & Health Policy) |
| Journal's citation record | 0 / 4 | Journal of Market Access & Health Policy: journal h-index 37 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Bregt S Kappelhoff: h-index 13 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Boehringer Ingelheim (Netherlands): institution h-index 55 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41573699) |
| Free to read | 2 / 2 | Free to read |
| Total | 30 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.3390/jmahp14010002
- PubMed: 41573699
- Original source →
- Free full text: Journal of Market Access & Health Policy →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Burgmans, S., Hald, A. R., Markandaier, S. T., Hall, N. M., Loiseau, R., Lie, X., et al. (2025). Overcoming Patient Access Barriers in Complex Conditions: Lessons from Schizophrenia for Broader Healthcare Applications. Journal of Market Access & Health Policy. https://doi.org/10.3390/jmahp14010002
Vancouver
Burgmans S, Hald AR, Markandaier ST, Hall NM, Loiseau R, Lie X, et al. Overcoming Patient Access Barriers in Complex Conditions: Lessons from Schizophrenia for Broader Healthcare Applications. Journal of Market Access & Health Policy. 2025. doi:10.3390/jmahp14010002. PMID: 41573699.
BibTeX
@article{burgmans2025-41573699,
author = {Burgmans, Saartje and Hald, Anne Rieper and Markandaier, Sayagi Tina and Hall, N. M. and Loiseau, Rafael and Lie, Xandra and Kappelhoff, Bregt S},
title = {{Overcoming Patient Access Barriers in Complex Conditions: Lessons from Schizophrenia for Broader Healthcare Applications}},
journal = {Journal of Market Access \& Health Policy},
year = {2025},
doi = {10.3390/jmahp14010002},
pmid = {41573699},
url = {https://doi.org/10.3390/jmahp14010002}
}
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