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Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS)

  • Saeed Farooq (a1), Zahid Nazar (a2), Muhammad Irfan (a2), Javed Akhter (a3), Ejaz Gul (a2), Uma Irfan (a4) and Farooq Naeem (a5)...

Abstract

Background

Most people with schizophrenia in low- and middle-income (LAMI) countries receive minimal formal care, and there are high rates of non-adherence to medication.

Aims

To evaluate the effectiveness of an intervention that involves a family member in supervising medication administration – supervised treatment in out-patients for schizophrenia (STOPS) – in improving treatment adherence and clinical outcomes.

Method

Individuals (n = 110) with schizophrenia or schizoaffective disorders were allocated to STOPS or to treatment as usual (TAU) and followed up for 1 year. The primary outcome was adherence to the treatment regimen. Positive and Negative Syndrome Scale for Schizophrenia and Global Assessment of Functioning scores were also assessed.

Results

Participants in the STOPS group had better adherence (complete adherence: 37 (67.3%) in STOPS v. 25 (45.5%) in TAU; P<0.02) and significant improvement in symptoms and functioning.

Conclusions

STOPS may be useful in enhancing adherence to treatment for schizophrenia in LAMI countries.

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Copyright

Corresponding author

Saeed Farooq, Corner House Resource Centre, 300 Dunstall Road, Whitmore Reans, Wolverhampton WV6 0NZ, UK. Email: sfarooqlrh@yahoo.com

Footnotes

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Declaration of interest

None.

Footnotes

References

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Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS)

  • Saeed Farooq (a1), Zahid Nazar (a2), Muhammad Irfan (a2), Javed Akhter (a3), Ejaz Gul (a2), Uma Irfan (a4) and Farooq Naeem (a5)...
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eLetters

Supervised treatment in out-patients for schizophrenia

MOHINDER KAPOOR, ST6 Old Age Psychiatry
13 January 2012

Farooq et al 1present an interesting paper looking at the effectiveness of an intervention that involves a family member in supervising medication administration -supervised treatment in out-patients for schizophrenia (STOPS) - in improving treatment adherence and clinical outcomes.

The authors rightly acknowledge the limitations of their study. They mention the provision of free drugs could have contributed to the better outcome in the STOPS group. However, they mention evidence suggests that even if drugs were free, non-adherence might have persisted. Also the participants in the treatment as usual (TAU) group had the option of accessing free drugs from the social welfare department. They go on to state that inspite of the limitations the difference between the STOPS andTAU group were minimal. I don't think this difference was minimal. This is because the authors themselves mention the drug supply for the TAU group could have varied in supply and quality, as it was dependent upon local pharmacies. Therefore, there is an issue of not only provision but also access to drugs and quality of drugs. So it raises the question that although in theory the TAU group had the option of accessing free drugs but in practice there could have been not only shortage but also difference in quality of drugs available to this group. This could have led to difference in improvement in symptoms and functioning between STOPSand TAU groups.

Declaration of interest: None

References:

1.Farooq S et al. Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS). Br J Psychiatry 2011; 199: 467-472.

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Conflict of interest: None declared

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