Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T15:25:28.122Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of medication-related factors on adherence in people with schizophrenia: A European multi-centre study

Published online by Cambridge University Press:  11 April 2011

Johanna Meier ,
Thomas Becker ,
Anita Patel ,
Debbie Robson ,
Aart Schene ,
Martijn Kikkert ,
Corrado Barbui ,
Lorenzo Burti  and
Bernd Puschner
Johanna Meier
Affiliation:
Department of Child and Adolescent Psychiatry, Leipzing University, Leipzing (Germany)
Thomas Becker
Affiliation:
Department of Psychiatry II, Ulm University, Ulm (Germany)
Anita Patel
Affiliation:
Institute of Psychiatry King's College London, King's Health Partners, London (United Kingdom)
Debbie Robson
Affiliation:
Institute of Psychiatry King's College London, King's Health Partners, London (United Kingdom)
Aart Schene
Affiliation:
Department of Psychiatry, Academic Medical Center, Amsterdam (The Netherlands)
Martijn Kikkert
Affiliation:
Department of Psychiatry, Academic Medical Center, Amsterdam (The Netherlands)
Corrado Barbui
Affiliation:
Department of Medicine and Public Health, Verona University (Italy)
Lorenzo Burti
Affiliation:
Department of Medicine and Public Health, Verona University (Italy)
Bernd Puschner*
Affiliation:
Department of Child and Adolescent Psychiatry, Leipzing University, Leipzing (Germany)
*
Address for correspondence: Dr. B. Puschner, Department of Psychiatry II, Ulm University Ludwig-Heilmeyer-Str. 2, 898321 Günzburg (Germany) Fax: +49–8221–96–28160 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Aim – To investigate the relation between medication-related factors and adherence in people with schizophrenia in outpatient treatment. Methods – The sample comprised 409 outpatients (ICD-10 diagnosis of schizophrenia) with clinician-rated instability in four European cities (Amsterdam, The Netherlands; Verona, Italy; Leipzig, Germany; London, Great Britain). Adherence was assessed using the Medication Adherence Questionnaire (patient perspective), and the Clinician Rating Scale (clinician perspective). Examined medication-related factors were type (atypical vs. typical), application (oral vs. depot), daily dose frequency of antipsychotic medication (Medication History Scale), number of side effects (Liverpool University Neuroleptic Side Effect Rating Scale), and patient attitudes toward medication (Drug Attitude Inventory). Multiple regression analysis was used to identify predictors of adherence by medication-related factors. Results – Adherence, as rated by patient and clinician, was predicted by patient attitude towards medication, but was unrelated to type of drug, formulation or side effects of antipsychotic medication. A high daily dose frequency was associated with better adherence, but only when rated by the patient. Conclusions – In order to improve adherence there is a need to seriously consider and attempt to improve patient attitude toward medication. However, type of antipsychotic and other medication-related factors may not be as closely related to adherence as it has often been suggested.

Declaration of Interest: The study was funded by a grant from the Quality of Life and Management of Living Resources Program of the European Union (QLG4-CT-2001–01734). JM, AS, CB, MK, CB, LB, and BP declare that they have not received any form of financing including pharmaceutical company support or any honoraria for consultancies or interventions during the last two years. DR has received honoraria from Eli Lilly, Janssen Cilag and Astra Zeneca for consultancy work, and Anita Patel has received research consultancy funding from Servier. TB reports research funding to the department from Astra Zeneca, GlaxoSmithKline and Affectis for clinical trials and investigator-initiated trials; the department has also received funds to a minor extent for symposia and in-house training from Astra Zeneca, Bristol-Myers Squibb, Eisai, Janssen Cilag, Lilly Germany, Lundbeck, Novartis, Pfizer, Servier, and Wyeth. All authors declare that they have no other involvements that might be considered a conflict of interest in connection with this article.

Keywords

schizophreniaadherencecomplianceantipsychotic drugsmultivariate analysis.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 19 , Issue 3 , September 2010 , pp. 251 - 259
Copyright
Copyright © Cambridge University Press 2010

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

REFERENCES

American Psychiatric Association (1987). Diagnostic and Statistical Manual, 3rd Ed. Revised. American Psychiatric Press: Washington, DC.Google Scholar
Ascher-Svanum, H., Zhu, B., Faries, D., Landbloom, R., Swartz, M. & Swanson, J. (2006). Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia. BMC Psychiatry 6, 8–24.CrossRefGoogle ScholarPubMed
Balestrieri, M., Di Sciascio, G., Isola, M., Lomonaco, E., Maso, E., Merli, R., Calo, S. & Bellantuono, C. (2009). Drug attitude and subjective well-being in antipsychotic treatment monotherapy in real-world settings. Epidemiologia e Psichiatria Sociale 18, 114–118.CrossRefGoogle ScholarPubMed
Bordenave-Gabriel, C., Giraud-Baro, E., De Beauchamp, I, Bougerol, T. & Calop, J. (2003). Why psychotic patients are not drug compliant? Encéphale 29, 213–222.Google Scholar
Byerly, M., Fisher, R., Whatley, K., Holland, R., Varghese, F., Carmody, T., Magouirk, B. & Rush, A.J. (2005). A comparison of electronic monitoring vs. clinician rating of antipsychotic adherence in outpatients with schizophrenia. Psychiatry Research 133, 129–133.CrossRefGoogle ScholarPubMed
Chisholm, D., Knapp, M. R., Knudsen, H. C., Amaddeo, F., Gaite, L. & van Wijngaarden, B. (2000). Client Socio-Demographic and Service Receipt Inventory--European Version: development of an instrument for international research. EPSILON Study 5. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs. British Journal of Psychiatry, Suppl. 39, 28–33.CrossRefGoogle Scholar
Claxton, A. J., Cramer, J. & Pierce, C. (2001). A systematic review of the associations between dose regimens and medication compliance. Clinical Therapeutics 23, 1296–1310.CrossRefGoogle ScholarPubMed
David, A. (1990). Schedule for assessment of insight into psychosis. British Journal of Psychiatry 156, 798–803.CrossRefGoogle Scholar
Davis, J. M., Matalon, L., Watanabe, M. D., Blake, L. & Metalon, L. (1994). Depot antipsychotic drugs. Place in therapy. Drugs 47, 741–773.CrossRefGoogle ScholarPubMed
Day, J. C., Wood, G., Dewey, M. & Bentall, R.P. (1995). A self-rating scale for measuring neuroleptic side-effects. Validation in a group of schizophrenic patients. British Journal of Psychiatry 166, 650–653.CrossRefGoogle Scholar
Day, J. C., Bentall, R. P., Roberts, C., Randall, F., Rogers, A., Cattell, D., Healy, D., Rae, P. & Power, C. (2005). Attitudes toward antipsychot-ic medication: the impact of clinical variables and relationships with health professionals. Archives of General Psychiatry 62, 717–724.CrossRefGoogle ScholarPubMed
Diaz, E., Neuse, E., Sullivan, M. C., Pearsall, H. R. & Woods, S. W. (2004). Adherence to conventional and atypical antipsychotics after hospital discharge. Journal of ClinicalPsychiatry 65, 354–360.Google ScholarPubMed
Dolder, C. R., Lacro, J. P., Dunn, L. B. & Jeste, D. V. (2002). Antipsychotic medication adherence: is there a difference between typical and atypical agents? American Journal of Psychiatry 159, 103–108.CrossRefGoogle Scholar
Donohoe, G., Owens, N., O'Donnell, C., Burke, T., Moore, L., Tobin, A. & O'Callaghan, E. (2001). Predictors of compliance with neuroleptic medication among inpatients with schizophrenia: a discriminant function analysis. European Psychiatry 16, 293–298.CrossRefGoogle ScholarPubMed
Dunayevich, E., Ascher-Svanum, H., Zhao, F., Jacobson, J. G., Phillips, G. A., Dellva, M. A. & Green, A. I. (2007). Longer time to antipsy-chotic treatment discontinuation for any cause is associated with better functional outcomes for patients with schizophrenia, schizo-phreniform disorder, or schizoaffective disorder. Journal of Clinical Psychiatry 68, 1163–1171.CrossRefGoogle ScholarPubMed
Fenton, W. S., Blyler, C. R. & Heinssen, R. K. (1997). Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin 23, 637–651.CrossRefGoogle ScholarPubMed
George, C. F., Peveler, R. C., Heiliger, S. & Thompson, C. (2000). Compliance with tricyclic antidepressants: the value of four different methods of assessment. British Journal of Clinical Pharmacology 50, 166–171.CrossRefGoogle ScholarPubMed
Gianfrancesco, F.D., Rajagopalan, K., Sajatovic, M. & Wang, R. H. (2006). Treatment adherence among patients with bipolar or manic disorder taking atypical and typical antipsychotics. Journal of Clinical Psychiatry 67, 222–232.CrossRefGoogle ScholarPubMed
Gray, R., Wykes, T. & Gournay, K. (2002). From compliance to concordance: A review of the literature on interventions to enhance compliance with antipsychotic medication. Journal of Psychiatric and Mental Health Nursing 9, 277–284.CrossRefGoogle ScholarPubMed
Gray, R., Leese, M., Bindman, J., Becker, T., Burti, L., David, A., Gournay, K., Kikkert, M., Koeter, M., Puschner, B., Schene, A., Thornicroft, G. & Tansella, M. (2006). Adherence therapy for people with schizophrenia: European multicentre randomised controlled trial. British Journal of Psychiatry 189, 508–514.CrossRefGoogle ScholarPubMed
Grunebaum, M. F., Weiden, P. J. & Olfson, M. (2001). Medication supervision and adherence of persons with psychotic disorders in residential treatment settings: a pilot study. Journal of Clinical Psychiatry 62, 394–399.CrossRefGoogle ScholarPubMed
Hogan, T. P. & Awad, A. G. (1992). Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures. Psychological Medicine 22, 347–352.CrossRefGoogle ScholarPubMed
Hogan, T. P., Awad, A. G. & Eastwood, R. (1983). A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychological Medicine 13, 177–183.CrossRefGoogle ScholarPubMed
Hui, C. L., Chen, E. Y., Kan, C., Yip, K., Law, C. & Chiu, C. P. (2006). Anti-psychotics adherence among out-patients with schizophrenia in Hong Kong. Keio Journal of Medicine 55, 9–14.CrossRefGoogle ScholarPubMed
Jones, S. H., Thornicroft, G., Coffey, M. & Dunn, G. (1995). A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). British Journal of Psychiatry 166, 654–659.CrossRefGoogle ScholarPubMed
Kahn, R. S., Fleischhacker, W. W., Boter, H., Davidson, M., Vergouwe, Y., Keet, I. P., Gheorghe, M. D., Rybakowski, J. K., Galderisi, S., Libiger, J., Hummer, M., Dollfus, S., Lopez-Ibor, J. J., Hranov, L. G., Gaebel, W., Peuskens, J., Lindefors, N., Riecher-Roessler, A. & Grobbee, D. E. (2008). Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet 371, 1085–1097.CrossRefGoogle ScholarPubMed
Kampman, O., Laippala, P., Vaananen, J., Koivisto, E., Kiviniemi, P., Kilkku, N. & LehtinenK. (2002). Indicators of medication compliance in first-episode psychosis. Psychiatry Research 110, 39–48.CrossRefGoogle ScholarPubMed
Kemp, R. & David, A. (1996). Psychological predictors of insight and compliance in psychotic patients. British Journal of Psychiatry 169, 444–450.CrossRefGoogle ScholarPubMed
Kemp, R., Kirov, G., Everitt, B., Hayward, P. & David, A. (1998). Randomised controlled trial of compliance therapy: 18-month follow-up. British Journal of Psychiatry 172, 413–419.CrossRefGoogle ScholarPubMed
Kikkert, M.J., Barbui, C., Koeter, M. W., David, A. S., Leese, M., Tansella, M., Gieler, A., Puschner, B. & Schene, A. H. (2008). Assessment of medication adherence in patients with schizophrenia: the Achilles heel of adherence research. Journal of Nervous and Mental Disease 196, 274–281.CrossRefGoogle ScholarPubMed
Lacro, J. P., Dunn, L. B., Dolder, C. R., Leckband, S. G. & Jeste, D. V. (2002). Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. Journal of Clinical Psychiatry 63, 892–909.CrossRefGoogle ScholarPubMed
Liao, T. F. (1994). Interpreting Probability Models. Sage: Thousand Oaks, California.CrossRefGoogle Scholar
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., Keefe, R. S., Davis, S. M., Davis, C. E., Lebowitz, B. D., Severe, J. & Hsiao, J. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine 353, 1209–1223.CrossRefGoogle ScholarPubMed
Llorca, P. M., Miadi-Fargier, H., Lancon, C., Jasso, M. G., Casadebaig, F., Philippe, A., Guillon, P., Mehnert, A., Omnes, L. F., Chicoye, A. & Durand-Zaleski, I. (2005). Cost-effectiveness analysis of schizophrenic patient care settings: impact of an atypical antipsychotic under long-acting injection formulation. Encéphale 31, 235–246.CrossRefGoogle ScholarPubMed
Loffler, W., Kilian, R., Toumi, M. & Angermeyer, M. C. (2003). Schizophrenic patients' subjective reasons for compliance and non-compliance with neuroleptic treatment. Pharmacopsychiatry 36, 105–112.Google Scholar
Menzin, J., Boulanger, L., Friedman, M., Mackell, J. & Lloyd, J. R. (2003). Treatment adherence associated with conventional and atypical antipsychotics in a large state Medicaid program. Psychiatric Services 54, 719–723.CrossRefGoogle Scholar
Morisky, D. E., Green, L. W. & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care 24, 67–74.CrossRefGoogle ScholarPubMed
Morrison, P., Gaskill, D., Meehan, T., Lunney, P., Lawrence, G. & Collings, P. (2000). The use of the Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) in clinical practice. Australian and New Zealand Journal of Mental Health Nursing 9, 166–176.CrossRefGoogle ScholarPubMed
Nageotte, C., Sullivan, G., Duan, N. & Camp, P. L. (1997). Medication compliance among the seriously mentally ill in a public mental health system. Social Psychiatry and Psychiatric Epidemiology 32, 49–56.CrossRefGoogle Scholar
Nakonezny, P. A. & Byerly, M. J. (2006). Electronically monitored adherence in outpatients with schizophrenia or schizoaffective disorder: a comparison of first- vs. second-generation antipsychotics. Schizophrenia Research 82, 107–114.CrossRefGoogle ScholarPubMed
Nosé, M., Barbui, C., Gray, R. & Tansella, M. (2003). Clinical interventions for treatment non-adherence in psychosis: Meta-analysis. British Journal of Psychiatry 183, 197–206.CrossRefGoogle ScholarPubMed
Novak-Grubic, V. & Tavcar, R. (1999). Treatment compliance in firstepisode schizophrenia. Psychiatric Services 50, 970–971.CrossRefGoogle ScholarPubMed
Olfson, M., Mechanic, D., Hansell, S., Boyer, C. A., Walkup, J. & Weiden, P. J. (2000). Predicting medication noncompliance after hospital discharge among patients with schizophrenia. Psychiatric Services 51, 216–222.CrossRefGoogle ScholarPubMed
Razali, M. S. & Yahya, H. (1995). Compliance with treatment in schizophrenia: a drug intervention program in a developing country. Acta Psychiatrica Scandinavica 91, 331–335.CrossRefGoogle ScholarPubMed
Rettenbacher, M. A., Hofer, A., Eder, U., Hummer, M., Kemmler, G., Weiss, E. M. & Fleischhacker, W. W. (2004). Compliance in schizophrenia: psychopathology, side effects, and patients' attitudes toward the illness and medication. Journal of Clinical Psychiatry 65, 1211–1218.CrossRefGoogle ScholarPubMed
Robinson, D., Woerner, M. G., Alvir, J. M., Bilder, R., Goldman, R., Geisler, S., Koreen, A., Sheitman, B., Chakos, M., Mayerhoff, D. & Lieberman, J. A. (1999). Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Archives of General Psychiatry 56, 241–247.CrossRefGoogle ScholarPubMed
Rosenheck, R., Cramer, J., Xu, W., Thomas, J., Henderson, W., Frisman, L., Fye, C. & Charney, D. (1997). A comparison of clozapine and haloperidol in hospitalized patients with refractory schizophrenia. Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia. New England Journal of Medicine 337, 809–815.CrossRefGoogle Scholar
Rosenheck, R., Chang, S., Choe, Y., Cramer, J., Xu, W., Thomas, J., Henderson, W. & Charney, D. (2000). Medication continuation and compliance: a comparison of patients treated with clozapine and haloperidol. Journal of Clinical Psychiatry 61, 382–386.CrossRefGoogle ScholarPubMed
Ruscher, S.M., de Wit, R. & Mazmanian, D. (1997). Psychiatric patients' attitudes about medication and factors affecting noncompliance. Psychiatric Services 48, 82–85.Google ScholarPubMed
Thieda, P., Beard, S., Richter, A. & Kane, J. (2003). An economic review of compliance with medication therapy in the treatment of schizophrenia. Psychiatric Services 54, 508–516.CrossRefGoogle ScholarPubMed
Thornicroft, G., Becker, T., Knapp, M., Schene, A., Tansella, M. & Vasquez Barquero, J. L. (2000). Quality of Life Following Adherence Therapy for People Disabled by Schizophrenia and Their Carers (Study Protocol). Health Services Research Department at the Institute of Psychiatry: London.Google Scholar
Velligan, D. I., Lam, Y. W., Glahn, D. C., Barrett, J. A., Maples, N. J., Ereshefsky, L. & Miller, A. L. (2006). Defining and assessing adherence to oral antipsychotics: a review of the literature. Schizophrenia Bulletin 32, 724–742.CrossRefGoogle ScholarPubMed
Ventura, J., Green, M. F., Shaner, A. & Liberman, R. P. (1993). Training and quality assurance with the brief psychiatric rating scale: ‘The drift busters’. International Journal of Methods in Psychiatric Research 3, 221–244.Google Scholar
Viguera, A. C., Baldessarini, R. J., Hegarty, J. D., van Kammen, D. P. & Tohen, M. (1997). Clinical risk following abrupt and gradual withdrawal of maintenance neuroleptic treatment. Archives of General Psychiatry 54, 49–55.CrossRefGoogle ScholarPubMed
Weiden, P. J. & Olfson, M. (1995). Cost of relapse in schizophrenia. Schizophrenia Bulletin 21, 419–429.CrossRefGoogle ScholarPubMed
Wolters, H. A., Knegtering, H., van den Bosch, R. J. & Wiersma, D. (2009). Effects and side effects of antipsychotic treatment in schizophrenia: pros and cons of available self-rating scales. Schizophrenia Research 112, 114–118.CrossRefGoogle ScholarPubMed
Young, J. L., Zonana, H. V. & Shepler, L. (1986). Medication noncompli-ance in schizophrenia: codification and update. Bulletin of the American Academy of Psychiatry and the Law 14, 105–122.Google ScholarPubMed