Hostname: page-component-7c8c6479df-p566r Total loading time: 0 Render date: 2024-03-28T09:23:58.127Z Has data issue: false hasContentIssue false

A prospective evaluation of adherence to medication in first episode schizophrenia

Published online by Cambridge University Press:  16 April 2020

M. Kamali
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
B.D. Kelly
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 7Dublin, Ireland
M. Clarke
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
S. Browne
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland Department of Psychiatry, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland
M. Gervin
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
A. Kinsella
Affiliation:
School of Mathematics, Dublin Institute of Technology, Dublin, Ireland
A. Lane
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
C. Larkin
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
E. O'Callaghan*
Affiliation:
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland St Vincent's University Hospital, Department of Psychiatry, University College Dublin, Ireland DELTA/DETECT Early Intervention in Psychosis Service, Dun Laoghaire, Ireland
*
*Corresponding author. Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St John of God, Cluain Mhuire Service, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland. E-mail address:eadbhard.ocallaghan@sjog.ie (E. O'Callaghan).
Get access

Abstract

The aim of this study was to identify the features of first episode schizophrenia that predict adherence antipsychotic medication at six-month follow-up. We used validated instruments to assess clinical and socio-demographic variables in all patients with first episode schizophrenia from a defined geographical area admitted to a Dublin psychiatric hospital over a four-year period (N = 100). At six-month follow-up (N = 60) we assessed adherence to medication using the Compliance Interview. One third of patients with schizophrenia were non-adherent with medication within six months of their first episode of illness. High levels of positive symptoms at baseline, lack of insight at baseline, alcohol misuse at baseline and previous drug misuse predict non-adherence. These results indicate that an identifiable subgroup of patients with first episode schizophrenia is at high risk of early non-adherence to medication. While high positive symptom scores pre-date and predict non-adherence in most patients, reduced insight is the best predictor of non-adherence in patients who do not misuse alcohol or other drugs.

Type
Original article
Copyright
Copyright © Elsevier SAS 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, SGHowe, JTPredicting medication compliance in a psychotic population. J. Nerv. Ment. Dis. 1993;181:558560.CrossRefGoogle Scholar
Bartko, GHerczeg, IZador, GClinical symptomatology and drug compliance in schizophrenic patients. Acta Psychiatr. Scand. 1988;77:7476.CrossRefGoogle ScholarPubMed
Buchanan, AA two year prospective study of treatment compliance in patients with schizophrenia. Psychol. Med. 1992;22:787797.CrossRefGoogle ScholarPubMed
Cramer, JAMattson, RHPrevey, MLScheyer, RDOulette, VLHow often is medication taken as prescribed? A novel assessment technique. JAMA 1989;261:32733277.CrossRefGoogle ScholarPubMed
Dew, MAKormos, RLRoth, LHMurali, SDiMartini, AGriffith, BPEarly post-transplant medical compliance and mental health predict physical morbidity and mortality one to three years after heart transplantation. J. Heart Lung Transplant. 1999;18:549562.CrossRefGoogle ScholarPubMed
Diaz, ELevine, HBSullivan, MCSernyak, MJHawkins, KACramer, JAet al.Use of the medication event monitoring system to estimate medication compliance in patients with schizophrenia. J. Psychiatry Neurosci. 2001;26:325329.Google ScholarPubMed
Drake, REOsher, FCWallach, MAAlcohol use and abuse in schizophrenia. J. Nerv. Ment. Dis. 1989;177:408414.CrossRefGoogle Scholar
Dusing, RAdverse events, compliance and changes in therapy. Curr. Hypertens. Rep. 2001;3:488492.CrossRefGoogle ScholarPubMed
Fenton, WSBlyler, CRHeinssen, RKDeterminants of Medication Compliance in Schizophrenia: Empirical and Clinical Findings. Schizophr. Bull. 1997;23:637651.CrossRefGoogle ScholarPubMed
Fleischaker, WWMeise, UGunther, VKurz, MCompliance with antipsychotic drug treatment: influence of side effects. Acta Psychiatr. Scand. 1994;89:1115.Google Scholar
Haynes, RBCompliance in Health Care. In: Haynes, RBSackett, DLTaylor, DW, Introduction Baltimore; MD: Johns Hopkins University Press; 1979Google Scholar
Hippocrates. Hippocrates: Volume 2 (8th printing) (trans W. H. S. Jones). Harvard: Harvard University Press; 1923.Google Scholar
Kamali, MKelly, LGervin, MBrowne, SLarkin, CO’Callaghan, EThe prevalence of comorbid substance misuse and its influence on suicidal ideation among in-patients with schizophrenia. Acta Psychiatr. Scand. 2000;101:452456.CrossRefGoogle ScholarPubMed
Kamali, MKelly, LGervin, MBrowne, SLarkin, CO’Callaghan, EPsychopharmacology: insight and comorbid substance misuse and medication compliance among patients with schizophrenia. Psychiatr. Serv. 2001;52:387388.CrossRefGoogle ScholarPubMed
Kashner, TMRader, LERodell, DEBeck, CMRodell, LRMller, KFamily characteristics, substance abuse and hospitalisation patterns of patients with schizophrenia. Hosp. Community Psychiatry 1987;42:195197.Google Scholar
Kay, SRFiszbein, AOpler, LAThe positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr. Bull. 1987;13:261276.CrossRefGoogle Scholar
Lim, LLEstimating compliance to study medication from serum drug levels: application to an AIDS clinical trial of zidovudine. Biometrics 1992;48:619630.CrossRefGoogle Scholar
Marder, SRMebane, AChien, CPWinslade, WJSwann, EVan Putten, TA comparison of patients who refuse and consent to neuroleptic treatment. Am. J. Psychiatry 1983;140:470472.Google ScholarPubMed
MacPherson, RJerrom, BHughes, AA controlled study of education about drug treatment in schizophrenia. Br. J. Psychiatry 1996;168:709717.CrossRefGoogle Scholar
MacPherson, RJerrom, BHughes, ARelationship between insight, educational background and cognition in schizophrenia. Br. J. Psychiatry 1996;168:718722.CrossRefGoogle ScholarPubMed
Novak-Grubi, VTavcar, RTreatment Compliance in First-Episode Schizophrenia. Psychiatr. Serv. 1999;50:970971.CrossRefGoogle Scholar
Owen, RRFischer, EPBooth, BMCuffel, BJMedication non-compliance and substance abuse among patients with schizophrenia. Psychiatr. Serv. 1996;47:853885.Google ScholarPubMed
Pan, PCTantam, DClinical characteristics, health beliefs and compliance with maintenance treatment: A comparison between regular and irregular attenders at a depot clinic. Acta Psychiatr. Scand. 1989;76:564570.CrossRefGoogle Scholar
Spitzer, RLWilliams, JBStructured Clinical Interview for DSM-III-R – Patient Version (SCID-P) New York: New York State Psychiatric Institute, Biometrics Research; 1986.Google Scholar
Inc SPSS SPSS User Guide Base Statistics 6.1. Chicago: SPSS Inc.; 1994.Google Scholar
Verdoux, HLengronne, JLiraud, FGonzale, BAssens, FAbalan, Fet al.Medication adherence in psychosis: predictors and impact on outcome. A 2-year follow-up of first-admitted patients. Acta Psychiatr. Scand. 2000;102:203210.CrossRefGoogle Scholar
Weiden, PJOlfson, MMeasuring costs of rehospitalisation in schizophrenia (presentation). San Francisco, California: American Psychiatric Association; 1993.Google Scholar
Wiersma, DNienhuis, FJSloof, CJGiel, RNatural course of schizophrenic disorders: a 15-year followup of a Dutch incidence cohort. Schizophr. Bull. 1988;24:7585.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.