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Antipsychotic Adherence Intervention for Veterans over 40 with Schizophrenia: Results of a Pilot Study

Published online by Cambridge University Press:  16 April 2020

D. Mittal ,
R. Owen ,
J. Lacro ,
R. Landes ,
M. Edlund ,
M. Valenstein  and
D. Jeste
D. Mittal
Affiliation:
Psychiatry, Central Arkansas Veterans Healthcare System, North Little Rock, USA
R. Owen
Affiliation:
Psychiatry, Central Arkansas Veterans Healthcare System, North Little Rock, USA
J. Lacro
Affiliation:
Psychiatry, San Diego Veterans Healthcare System, San Diego, USA
R. Landes
Affiliation:
Biostatistics, University of Arkansas for Medical Sciences, North Little Rock, USA
M. Edlund
Affiliation:
Psychiatry, Central Arkansas Veterans Healthcare System, North Little Rock, USA
M. Valenstein
Affiliation:
Psychiatry, Veterans Affairs Medical Center, Michigan, USA
D. Jeste
Affiliation:
Psychiatry, San Diego Veterans Healthcare System, San Diego, USA

Abstract

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This pilot study tested the feasibility, acceptability, and effect-sizes of a multimodal, individual intervention designed to optimize antipsychotic medication use in patients ≥40 years of age with schizophrenia or schizoaffective disorder.

Methods:

We randomized 40 patients into two groups: usual care (UC) or a nine-session, manualized, antipsychotic adherence intervention (AAI). the AAI attempted to improve adherence by combining three psychosocial techniques:

  1. a. education,

  2. b. skills training, and

  3. c. alliance building.

Sessions employed a semi-structured format to facilitate open communication. the primary outcome was antipsychotic adherence at study end. We obtained qualitative data regarding patient preferences for the duration and modality for receiving the adherence intervention.

Results:

Compared to the UC group, a greater proportion of the AAI group was adherent post-intervention based on medication possession ratio, a commonly used measure of medication adherence (85% vs. 66.6%; OR=2.64), a difference that was statistically not significant. the entire AAI group reported that they intended to take medications, and 75% were satisfied with the intervention.

Conclusions:

The AAI was feasible and acceptable. Preliminary data on its effectiveness warrant a larger study. Qualitative data shows that patients prefer brief adherence interventions and accept telephone strategies.

Type
P03-172
Information
European Psychiatry , Volume 24 , Issue S1: 17th EPA Congress - Lisbon, Portugal, January 2009, Abstract book , January 2009 , 24-E1171
Copyright
Copyright © European Psychiatric Association 2009
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