Adherence to Pharmacological Treatment Among Patients with Schizophrenia Adherence to Pharmacological Treatment Among Patients with Schizophrenia
Main Article Content
Keywords
Adherence, medication, schizophrenia, basrah
Abstract
ABSTRACT
Adherence to medication is the range to which an individual corresponds with the prescribed medication dosing regimen. Medication non-adherence among patients with schizophrenia is extremely common issue, broadly ranging from 4% to 72%. Medication non-adherence among schizophrenic patients has serious consequences for individuals as well as the health system such as relapse of symptoms, re-hospitalization, aggression, suicide, cognitive deterioration, loss of job and arrest, victimization, and overall unfavorable outcome. Factors determining adherence are divided into medication-related as side effects, patient-related as lack of insight, illness-related as persecutory delusions, sociocultural-related such as stigma, and clinician-related factors like poor therapeutic alliance. Improving adherence is best achieved by exploring the reasons for non-adherence with appropriate management plans to deal with them. Adherence can be improved by providing basic strategies that must routinely accompany every prescription, and specific interventions like psycho-social ones, antipsychotic long acting injections, reminders, service interventions, and may be even financial incentives.
References
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11. Asher L, Patel V, De Silva MJ. Community-based psychosocial interventions for people with schizophrenia in low and middle-income countries: systematic review and meta-analysis. BMC Psychiatry. 2017; 17(1):355.
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13. Harrison C, Charles J, Britt H. Comorbidities and risk factors among patients with schizophrenia. FOCUS. 2015; 44(11):781-3.
14. Gast A, Mathes T. Medication adherence influencing factors-an (updated) overview of systematic reviews. Syst Rev. 2019; 8(1):112.
15. Ata EE, Bahadir‐Yilmaz E, Bayrak NG. The impact of side effects on schizophrenia and bipolar disorder patients’ adherence to prescribed medical therapy. Perspect Psychiatr Care. 2020; 1-6.
16. Fernandez-Lazaro CI, García-González JM, Adams DP, et al. Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC Fam Pract. 2019; 20(1):132.
17. Alipour A, Gabrielson S, Patel PB. Ingestible Sensors and Medication Adherence: Focus on Use in Serious Mental Illness. Pharmacy. 2020; 8(2):103.
18. Tessier A, Dupuy M, Baylé FJ, et al. Brief interventions for improving adherence in schizophrenia: A pilot study using electronic medication event monitoring. Psychiatry Research. 2020; 285:112780.
19. Singh PM, Karmacharya S, Khadka S. Severity Of Relapse And Medication Adherence In Patient Of Schizophrenia: A Study From Nepal. J Psychiatr Assoc Nepal. 2019; 8(2):54-8.
20. Dobber J, Latour C, Van Meijel B, et al. Active Ingredients and Mechanisms of Change in Motivational Interviewing for Medication Adherence. A Mixed Methods Study of Patient-Therapist Interaction in Patients With Schizophrenia. Front. Psychiatry. 2020; 11:78.
21. Endale Gurmu A, Abdela E, Allele B, et al. Rate of Nonadherence to Antipsychotic Medications and Factors Leading to Nonadherence among Psychiatric Patients in Gondar University Hospital, Northwest Ethiopia. Advances in Psychiatry. 2014; 2014:1-5.
22. Taylor D, Barnes TRE, Young AH. The Maudsley prescribing guidelines in Psychiatry. 13th ed. Hoboken: Wiley; 2018.
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24. Gebeyehu DA, Mulat H, Bekana L, et al. Psychotropic medication non-adherence among patients with severe mental disorder attending at Bahir Dar Felege Hiwote Referral hospital, north west Ethiopia, 2017. BMC Res Notes. 2019; 12(1):102.
25. Lama A, Baruah A. Medication adherence and its association with subjective well-being among persons with schizophrenia. Indian J Psy Nsg. 2019; 16(2):61-6.
26. Torras MG, Tomas EP. INTERVENTIONS TO IMPROVE THERAPEUTIC ADHERENCE IN SUBJECTS WITH SCHIZOPHRENIA. Pap Psicol. 2018; 39(1):31-9.
27. Forma F, Green T, Kim S, et al. Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness. CEOR. 2020; 12:123-32.
28. Czobor P, Van Dorn RA, Citrome L, et al. Treatment adherence in schizophrenia: A patient-level meta-analysis of combined CATIE and EUFEST studies. European Neuropsychopharmacology. 2015; 25(8):1158-66.
29. Semahegn A, Torpey K, Manu A, et al. Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis. Syst Rev. 2020; 9(1):17.
30. Ahmed N, Gandhi S, Baruah A. Effectiveness of specific intervention on treatment adherence of persons with mental illness: A pilot study. Indian J Psychiatry. 2015; 57(4):403-6.
31. Okasha TA, Radwan DN, Elkholy H, et al. Psycho-demographic and clinical predictors of medication adherence in patients with bipolar I disorder in a university hospital in Egypt. S Afr J Psych. 2020; 26(0):a1437.
32. Fatma F, Baati I, Omri S, et al. Medication adherence in schizophrenia. Eur. psychiatr. 2016; 33(S1):S586.
33. Ibrahim AW, Pindar SK, Yerima MM, et al. Medication-related factors of non adherence among patients with schizophrenia and bipolar disorder: Outcome of a cross-sectional survey in Maiduguri, North eastern Nigeria. J. Neurosci. Behav. Health. 2015; 7(5):31-9.
34. Odo HO, Olotu SO, Soni JS, et al. Assessment of adherence to psychotropic medications among out-patients at the Pharmacy Department of a Psychiatric Hospital, in Benin City, Nigeria. Asian J Pharm. 2014; 8(4):211-5.
35. Lee Y, Lee M-S, Jeong H-G, et al. Medication Adherence Using Electronic Monitoring in Severe Psychiatric Illness: 4 and 24 Weeks after Discharge. Clin Psychopharmacol Neurosci. 2019; 17(2):288-96.
36. Mamo ES , Gelaw BK, Tegegne GT. Medication Adherence among Patients with Schizophrenia Treated with Antipsychotics at Adama Hospital, East Shoa Zone, Oromia Regional State. Adv Pharmacoepidemiol Drug Saf . 2016; 5(2):1000200.
37. Descalço NFF, Afonso PMM. Can Empathy Improve Therapeutic Adherence in Schizophrenia? Journal of Clinical Psychopharmacology. 2020; 40(1):89-90.
38. Atram U, Karia S, Shah N, et al. A Retrospective Study Of Treatment Compliance In Psychiatric Patients And Factors Affecting The Same. IJMH. 2016; 3(2):178-84.
39. Moritz S, Favrod J, Andreou C, et al. Beyond the Usual Suspects: Positive Attitudes Towards Positive Symptoms Is Associated With Medication Noncompliance in Psychosis. Schizophrenia Bulletin. 2013; 39(4):917-22.
40. Girma S, Abdisa E, Fikadu T. Prevalence of Antipsychotic Drug Non Adherence and Associated Factors Among Patients with Schizophrenia Attending at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: Institutional Based Cross Sectional Study. Health Sci J. 2017; 11(4):520
41. Kim J, Ozzoude M, Nakajima S, et al. Insight and medication adherence in schizophrenia: An analysis of the CATIE trial. Neuropharmacology. 2020; 168:1-8.
42. Chang JG, Roh D, Kim C-H. Association between Therapeutic Alliance and Adherence in Outpatient Schizophrenia Patients. Clin Psychopharmacol Neurosci. 2019; 17(2):273-8.
43. Ebrahem SM. Alam FH. Effectiveness of Psychiatric Nursing Intervention on Adherence to Medications and Quality of Life of Schizophrenic Patients. AJNS. 2016; 5(6):232-9.
44. Phan SV. Medication adherence in patients with schizophrenia. Int J Psychiatry Med. 2016; 51(2):211-9.
45. Eticha T, Teklu A, Ali D, et al. Factors Associated with Medication Adherence among Patients with Schizophrenia in Mekelle, Northern Ethiopia. PLoS ONE. 2015; 10(3):e0120560.
46. Ghimire SR. Poor Medication Compliance in Schizophrenia from an Illness and Treatment Perspective. ECPP. 2017; 3(4):131-41.
47. Hernandez M, Barrio C. Families and medication use and adherence among Latinos with schizophrenia. Journal of Mental Health. 2017; 26(1):14-20.
48. Beebe LH. Effect of a Telephone Intervention upon Medication Adherence and Related Outcomes in Outpatients with Schizophrenia Spectrum Disorders (SSDs). Med Clin Rev. 2017; 3(2):1-6.
49. Chandra IS, Kumar KL, Reddy MP, et al. Attitudes toward Medication and Reasons for Non-Compliance in Patients with Schizophrenia. Indian J Psychol Med. 2014; 36(3):294-8.
50. Dahan S, Behrbalk P, Greenberger C. Improving Adherence in Hospitalized Patients Diagnosed With Schizophrenia: An Integrative One-on-One Intervention. Archives of Psychiatric Nursing. 2016; 30(6):660-5.
51. Haddad PM, Brain C, Scott J. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies. PROM. 2014; 5:43-62.
52. Sarkhel S, Singh OP, Arora M. Clinical Practice Guidelines for Psychoeducation in Psychiatric Disorders General Principles of Psychoeducation. Indian J Psychiatry. 2020; 62(8):S319-23.
53. Dobber J, Latour C, de Haan L, et al. Medication adherence in patients with schizophrenia: a qualitative study of the patient process in motivational interviewing. BMC Psychiatry. 2018; 18(1):135.
54. Gray R, Bressington D, Ivanecka A, et al. Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis. BMC Psychiatry. 2016; 16(1):90.
55. Salzmann-Erikson M, Sjödin M. A narrative meta-synthesis of how people with schizophrenia experience facilitators and barriers in using antipsychotic medication: Implications for healthcare professionals. International Journal of Nursing Studies. 2018; 85:7-18.
56. Greene M, Yan T, Chang E, et al. Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder. Journal of Medical Economics. 2018; 21(2):127-34.
57. Ljungdalh PM. Non-adherence to pharmacological treatment in schizophrenia and schizophrenia spectrum disorders - An updated systematic literature review. The European Journal of Psychiatry. 2017; 31(4):172-86.
58. Velligan DI, Kamil SH. Enhancing patient adherence: introducing smart pill devices. Therapeutic Delivery. 2014; 5(6):611-3.
59. Guinart D, Kane JM. Use of Behavioral Economics to Improve Medication Adherence in Severe Mental Illness. PS. 2019; 70(10):955-7.
60. Noordraven EL, Wierdsma AI, Blanken P, et al. Financial incentives for improving adherence to maintenance treatment in patients with psychotic disorders (Money for Medication): a multicentre, open-label, randomised controlled trial. The Lancet Psychiatry. 2017; 4(3):199-207.
2. Tareke M, Tesfaye S, Amare D, et al. Antipsychotic medication non-adherence among schizophrenia patients in Central Ethiopia. S Afr J Psych. 2018; 24(0):a1124.
3. Ganti L, Kaufman MS, Blitzstein SM. First aid for the psychiatry clerkship. 5th ed. New York: McGraw-Hill Education; 2019.
4. Sadock BJ, Ahmad S, Sadock VA. Kaplan & Sadock’s pocket handbook of clinical psychiatry. 6th ed. Philadelphia: Wolters Kluwer; 2019.
5. Correll CU, Schooler NR. Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment. NDT. 2020; 16:519-34.
6. Epping EA, Black DW. Epidemiology and Risk Factors Influencing Schizophrenia. In: Schulz SC, Green MF, Nelson KJ (Eds). Schizophrenia and psychotic spectrum disorders. New York: Oxford University Press; 2016. p41-54.
7. Brar JS. Epidemiology of Schizophrenia. In: Marcsisin MJ, Gannon JM, Rosenstock JB (Eds). Schizophrenia and related disorders. New York: Oxford University Press; 2017. p89-110.
8. Harrison P, Cowen P, Burns T, et al. Shorter Oxford textbook of psychiatry. 7th ed. Oxford: Oxford University Press; 2018.
9. Ganguly P, Soliman A, Moustafa AA. Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment. Front. Public Health. 2018; 6:166.
10. Kassew T, Demilew D, Birhanu A, et al. Attitude towards Antipsychotic Medications in Patients Diagnosed with Schizophrenia: A Cross-Sectional Study at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Schizophrenia Research and Treatment. 2019; 2019:1-9.
11. Asher L, Patel V, De Silva MJ. Community-based psychosocial interventions for people with schizophrenia in low and middle-income countries: systematic review and meta-analysis. BMC Psychiatry. 2017; 17(1):355.
12. Radhakrishnan R, Ganesh S, Meltzer HY, et al. Schizophrenia. In: Ebert MH, Leckman JF, Petrakis IL (Eds). Current diagnosis & treatment. 3rd ed. New York: McGraw-Hill Education; 2019. p207-35.
13. Harrison C, Charles J, Britt H. Comorbidities and risk factors among patients with schizophrenia. FOCUS. 2015; 44(11):781-3.
14. Gast A, Mathes T. Medication adherence influencing factors-an (updated) overview of systematic reviews. Syst Rev. 2019; 8(1):112.
15. Ata EE, Bahadir‐Yilmaz E, Bayrak NG. The impact of side effects on schizophrenia and bipolar disorder patients’ adherence to prescribed medical therapy. Perspect Psychiatr Care. 2020; 1-6.
16. Fernandez-Lazaro CI, García-González JM, Adams DP, et al. Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC Fam Pract. 2019; 20(1):132.
17. Alipour A, Gabrielson S, Patel PB. Ingestible Sensors and Medication Adherence: Focus on Use in Serious Mental Illness. Pharmacy. 2020; 8(2):103.
18. Tessier A, Dupuy M, Baylé FJ, et al. Brief interventions for improving adherence in schizophrenia: A pilot study using electronic medication event monitoring. Psychiatry Research. 2020; 285:112780.
19. Singh PM, Karmacharya S, Khadka S. Severity Of Relapse And Medication Adherence In Patient Of Schizophrenia: A Study From Nepal. J Psychiatr Assoc Nepal. 2019; 8(2):54-8.
20. Dobber J, Latour C, Van Meijel B, et al. Active Ingredients and Mechanisms of Change in Motivational Interviewing for Medication Adherence. A Mixed Methods Study of Patient-Therapist Interaction in Patients With Schizophrenia. Front. Psychiatry. 2020; 11:78.
21. Endale Gurmu A, Abdela E, Allele B, et al. Rate of Nonadherence to Antipsychotic Medications and Factors Leading to Nonadherence among Psychiatric Patients in Gondar University Hospital, Northwest Ethiopia. Advances in Psychiatry. 2014; 2014:1-5.
22. Taylor D, Barnes TRE, Young AH. The Maudsley prescribing guidelines in Psychiatry. 13th ed. Hoboken: Wiley; 2018.
23. Grover S, Mehra A, Chakrabarti S, et al. Attitude toward psychotropic medications: A comparison of the elderly and adult patients with affective and psychotic disorders. J Geriatr Ment Health. 2020; 6(2):38-45.
24. Gebeyehu DA, Mulat H, Bekana L, et al. Psychotropic medication non-adherence among patients with severe mental disorder attending at Bahir Dar Felege Hiwote Referral hospital, north west Ethiopia, 2017. BMC Res Notes. 2019; 12(1):102.
25. Lama A, Baruah A. Medication adherence and its association with subjective well-being among persons with schizophrenia. Indian J Psy Nsg. 2019; 16(2):61-6.
26. Torras MG, Tomas EP. INTERVENTIONS TO IMPROVE THERAPEUTIC ADHERENCE IN SUBJECTS WITH SCHIZOPHRENIA. Pap Psicol. 2018; 39(1):31-9.
27. Forma F, Green T, Kim S, et al. Antipsychotic Medication Adherence and Healthcare Services Utilization in Two Cohorts of Patients with Serious Mental Illness. CEOR. 2020; 12:123-32.
28. Czobor P, Van Dorn RA, Citrome L, et al. Treatment adherence in schizophrenia: A patient-level meta-analysis of combined CATIE and EUFEST studies. European Neuropsychopharmacology. 2015; 25(8):1158-66.
29. Semahegn A, Torpey K, Manu A, et al. Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis. Syst Rev. 2020; 9(1):17.
30. Ahmed N, Gandhi S, Baruah A. Effectiveness of specific intervention on treatment adherence of persons with mental illness: A pilot study. Indian J Psychiatry. 2015; 57(4):403-6.
31. Okasha TA, Radwan DN, Elkholy H, et al. Psycho-demographic and clinical predictors of medication adherence in patients with bipolar I disorder in a university hospital in Egypt. S Afr J Psych. 2020; 26(0):a1437.
32. Fatma F, Baati I, Omri S, et al. Medication adherence in schizophrenia. Eur. psychiatr. 2016; 33(S1):S586.
33. Ibrahim AW, Pindar SK, Yerima MM, et al. Medication-related factors of non adherence among patients with schizophrenia and bipolar disorder: Outcome of a cross-sectional survey in Maiduguri, North eastern Nigeria. J. Neurosci. Behav. Health. 2015; 7(5):31-9.
34. Odo HO, Olotu SO, Soni JS, et al. Assessment of adherence to psychotropic medications among out-patients at the Pharmacy Department of a Psychiatric Hospital, in Benin City, Nigeria. Asian J Pharm. 2014; 8(4):211-5.
35. Lee Y, Lee M-S, Jeong H-G, et al. Medication Adherence Using Electronic Monitoring in Severe Psychiatric Illness: 4 and 24 Weeks after Discharge. Clin Psychopharmacol Neurosci. 2019; 17(2):288-96.
36. Mamo ES , Gelaw BK, Tegegne GT. Medication Adherence among Patients with Schizophrenia Treated with Antipsychotics at Adama Hospital, East Shoa Zone, Oromia Regional State. Adv Pharmacoepidemiol Drug Saf . 2016; 5(2):1000200.
37. Descalço NFF, Afonso PMM. Can Empathy Improve Therapeutic Adherence in Schizophrenia? Journal of Clinical Psychopharmacology. 2020; 40(1):89-90.
38. Atram U, Karia S, Shah N, et al. A Retrospective Study Of Treatment Compliance In Psychiatric Patients And Factors Affecting The Same. IJMH. 2016; 3(2):178-84.
39. Moritz S, Favrod J, Andreou C, et al. Beyond the Usual Suspects: Positive Attitudes Towards Positive Symptoms Is Associated With Medication Noncompliance in Psychosis. Schizophrenia Bulletin. 2013; 39(4):917-22.
40. Girma S, Abdisa E, Fikadu T. Prevalence of Antipsychotic Drug Non Adherence and Associated Factors Among Patients with Schizophrenia Attending at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: Institutional Based Cross Sectional Study. Health Sci J. 2017; 11(4):520
41. Kim J, Ozzoude M, Nakajima S, et al. Insight and medication adherence in schizophrenia: An analysis of the CATIE trial. Neuropharmacology. 2020; 168:1-8.
42. Chang JG, Roh D, Kim C-H. Association between Therapeutic Alliance and Adherence in Outpatient Schizophrenia Patients. Clin Psychopharmacol Neurosci. 2019; 17(2):273-8.
43. Ebrahem SM. Alam FH. Effectiveness of Psychiatric Nursing Intervention on Adherence to Medications and Quality of Life of Schizophrenic Patients. AJNS. 2016; 5(6):232-9.
44. Phan SV. Medication adherence in patients with schizophrenia. Int J Psychiatry Med. 2016; 51(2):211-9.
45. Eticha T, Teklu A, Ali D, et al. Factors Associated with Medication Adherence among Patients with Schizophrenia in Mekelle, Northern Ethiopia. PLoS ONE. 2015; 10(3):e0120560.
46. Ghimire SR. Poor Medication Compliance in Schizophrenia from an Illness and Treatment Perspective. ECPP. 2017; 3(4):131-41.
47. Hernandez M, Barrio C. Families and medication use and adherence among Latinos with schizophrenia. Journal of Mental Health. 2017; 26(1):14-20.
48. Beebe LH. Effect of a Telephone Intervention upon Medication Adherence and Related Outcomes in Outpatients with Schizophrenia Spectrum Disorders (SSDs). Med Clin Rev. 2017; 3(2):1-6.
49. Chandra IS, Kumar KL, Reddy MP, et al. Attitudes toward Medication and Reasons for Non-Compliance in Patients with Schizophrenia. Indian J Psychol Med. 2014; 36(3):294-8.
50. Dahan S, Behrbalk P, Greenberger C. Improving Adherence in Hospitalized Patients Diagnosed With Schizophrenia: An Integrative One-on-One Intervention. Archives of Psychiatric Nursing. 2016; 30(6):660-5.
51. Haddad PM, Brain C, Scott J. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies. PROM. 2014; 5:43-62.
52. Sarkhel S, Singh OP, Arora M. Clinical Practice Guidelines for Psychoeducation in Psychiatric Disorders General Principles of Psychoeducation. Indian J Psychiatry. 2020; 62(8):S319-23.
53. Dobber J, Latour C, de Haan L, et al. Medication adherence in patients with schizophrenia: a qualitative study of the patient process in motivational interviewing. BMC Psychiatry. 2018; 18(1):135.
54. Gray R, Bressington D, Ivanecka A, et al. Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis. BMC Psychiatry. 2016; 16(1):90.
55. Salzmann-Erikson M, Sjödin M. A narrative meta-synthesis of how people with schizophrenia experience facilitators and barriers in using antipsychotic medication: Implications for healthcare professionals. International Journal of Nursing Studies. 2018; 85:7-18.
56. Greene M, Yan T, Chang E, et al. Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder. Journal of Medical Economics. 2018; 21(2):127-34.
57. Ljungdalh PM. Non-adherence to pharmacological treatment in schizophrenia and schizophrenia spectrum disorders - An updated systematic literature review. The European Journal of Psychiatry. 2017; 31(4):172-86.
58. Velligan DI, Kamil SH. Enhancing patient adherence: introducing smart pill devices. Therapeutic Delivery. 2014; 5(6):611-3.
59. Guinart D, Kane JM. Use of Behavioral Economics to Improve Medication Adherence in Severe Mental Illness. PS. 2019; 70(10):955-7.
60. Noordraven EL, Wierdsma AI, Blanken P, et al. Financial incentives for improving adherence to maintenance treatment in patients with psychotic disorders (Money for Medication): a multicentre, open-label, randomised controlled trial. The Lancet Psychiatry. 2017; 4(3):199-207.
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Adherence to Pharmacological Treatment Among Patients with Schizophrenia: Adherence to Pharmacological Treatment Among Patients with Schizophrenia. Iraqi Natl J Med [Internet]. 2022 Jan. 15 [cited 2025 Mar. 14];4(1):31-42. Available from: https://iqnjm.com/index.php/homepage/article/view/62
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