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Medication Compliance in Psychotic Disorders
Janssen, Birgit., Gaebel, Wolfgang., Haerter, Martin, Komaharadi, F., Lindel, Birgit., & Weinmann, Stefan. (2006 April). "Evaluation of factors influencing medication compliance in inpatient treatment of psychotic disorders. Psychopharmacology 187:229-236.
The authors and researchers examine short- and long-term compliance to prescribed antipsychotic drugs. Their objective is to evaluate patient-related and treatment-related factors associated with medication compliance in inpatients with the following diagnoses: schizophrenia, schizoaffective disorder, and other psychotic disorders. The study is a "naturalistic study," based in seven hospitals with patients assessed weekly. The following characteristics were studied: social function, side-effects of medication, mental status, and compliance to medication requests. The researchers in this study attempted to determine whether medication is the basis for compliance or whether multiple factors including innate factors such as social influence and individual characteristics, environmental characteristics, genetic and personality characteristics were more likely to influence medication compliance in psychotic patients because medication compliance is so low among psychotic patients. Previous research suggests that medication compliance has less to do with medication alone and more to do with a combination of factors including traits associated with the psychosis of the patient.
The researchers in this study used logistic regression analysis to measure medication compliance. The results of the study showed a clear association between patient's compliance with orders and substance abuse and involuntary admission and compliance. Also relevant were...
The medication regime the patient took had little effect on medication compliance, showing a link between external traits to medication compliance. Atypical antipsychotic treatment seemed to be more effective than tradition medication treatment with regard to medication compliance. Patient-related factors may therefore according to the results of this research, be more significant than medication related regimes with regard to medication compliance.
Kemp, Roisin; Hayward, Peter; Applewhaite, Grantley; Everitt, Brian; David, Anthony. (1996
Feb). Compliance therapy in psychotic patients: Randomized controlled trial. BMJ, Vol 312.
The researchers and authors of this study attempt to determine whether compliance therapy which is a cognitive-behavioral intervention might improve medication compliance with treatment in psychotic patients. The researchers emphasize the importance of not relying on medication alone, or personality characteristics or naturalistic studies alone to solve the issue of medication compliance in patients with psychotic disorders. The researchers hypothesize that cognitive-behavioral interventions along with medication may improve social adjustment which will improve medication compliance as patients begin to realize benefits associated with fitting into society. Much of the lack of medication compliance may be associated more with the lack of viable results associated with the sense of psychosis. The researchers also explore whether if this improves social adjustment, whether this effect persisted six months following treatment. The design for the study is a randomized controlled trial…
Dolder, Christian R., Pharm.D., Jonathan P. Lacro, Pharm.D., Laura B. Dunn, M.D., and Dilip
V. Jeste., M.D (2002 Jan). Antipsychotic medication adherence: Is there a difference between typical and atypical agents? Am J. Psychiatry, 159:103-108.
The researchers and authors of this study had a primary objective of comparing medication adherence in outpatient veterans using typical vs. atypical antipsychotic agents. To accomplish this goal the researchers used pharmacy refill records; the patient selection criteria including patients using medications haloperidol, perphenazine, risperidone, olanzapine and quetiapine. Patients used medications for a 3-month period before using an atypical agent, and refill records were reviewed for a period of 12 months. The results of this study suggested that adherence rates were higher in patients receiving atypical agents, suggesting that medication compliance is more likely in patients receiving these agents compared to typical antipsychotic agents. Patient personality traits were not examined in this study, as in previous studies, so it is uncertain whether characteristics including aggression, addiction or other factors may have influenced compliance, as was the case in some previous studies. Patients were likely to miss medications seven times per month on typical antipsychotics vs. four times per month on atypical antipsychotics in this particular study. At the end of the study refill rates showed a four percent difference between typical and atypical agents, with approximately 54% of patients on atypical agents likely to refill their medications vs. roughly 50% of patients likely to comply with necessary refills on traditional or typical antipsychotics.
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