Non-adherence common in schizophrenia patients
A recent study on medication compliance shows that 40 percent of schizophrenia patients do not take their medication as prescribed. The study also showed that the severity of the illness and the patient’s attitude towards medication significantly affected their non-adherence.
“Lack of adherence to medication regimens is a critical issue in the treatment of schizophrenia and has serious impacts on the course of the illness, including worsening of symptoms, relapse, suicidal attempts, repeated emergency room visits or re-hospitalization, and poor functional outcomes,” says Seung-Hyun Kim, of the Korea University Research Institute of Mental Health in Seoul, Korea, and team. “The most common methods of assessing adherence are self-reports and physician reports. However, adherence to medication regimens in patients with schizophrenia may be overestimated by both patients and clinicians.”
An assessment on 51 schizophrenia patients was completed over an eight-week period on medication adherence. The investigation used four different methods of assessment, including pill counts, a self- reporting system, a clinical rating scale, and a Medication Event Monitoring System (MEMS), in which a microprocessor on medication bottles records the number of times the bottle is opened.
Researchers analyzed the relationship between patients’ medication adherence and their scores on the Positive and Negative Syndrome scale (PANSS), the Drug Attitude Inventory (DAI), as well as the Clinical Global Impression of Severity (CGIS) scale.
The MEMS identified that over the study period, 58.8 percent of patients were adherent to their medication routines. This was determined by medication containers being opened within three hours of each scheduled dose.
The MEMS method of assessing adherence rates was significantly lower than the other three methods of assessment, including the self reporting questionnaire which presented a 74.5 percent adherence rate, as well as the clinical rating scale and pill counts, which both reported a 92.2 percent adherence rate.
It was also discovered that patients who were considered non-adherent by the MEMS had much higher PANSS scores than adherent patients in terms of poor impulse control, excitement, and preoccupation symptoms.
Adherent patients also appeared to have a more positive attitude towards medication, represented by their higher DAI score, 4.30 compared to 2.38 in non-adherent patients.
“The results of this study agree with those of previous studies showing that non-adherence to antipsychotic medication in schizophrenia is common in outpatient practice settings,” Kim and his colleagues concluded. “Factors associated with non-adherence in the present study were higher symptom scores and attitude toward medication. These may represent modifiable risks that, if addressed, could lead to improved adherence and improved patient outcomes.”
Source—MedWire News
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