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The role of adherence to medication in the effectiveness of long-term treatment of schizophrenia

Published online by Cambridge University Press:  16 April 2020

J. Volavka ,
J.P. Lindenmayer ,
H. Liu-Seifert ,
P. Kulkarni ,
B.J. Kinon ,
V. Stauffer ,
B. Edwards ,
L. Chen ,
D.H. Adams  and
P.F. Buckley
...Show all authors
J. Volavka
Affiliation:
Department of Psychiatry, New York University, New York, NY, USA
J.P. Lindenmayer
Affiliation:
Department of Psychiatry, New York University, New York, NY, USA
H. Liu-Seifert
Affiliation:
Eli Lilly and Company, Indianapolis, IN, USA
P. Kulkarni
Affiliation:
Eli Lilly and Company, Indianapolis, IN, USA
B.J. Kinon
Affiliation:
Eli Lilly and Company, Indianapolis, IN, USA
V. Stauffer
Affiliation:
Eli Lilly and Company, Indianapolis, IN, USA
B. Edwards
Affiliation:
Eli Lilly and Company, Indianapolis, IN, USA
L. Chen
Affiliation:
Eli Lilly and Company, Indianapolis, IN, USA
D.H. Adams
Affiliation:
Eli Lilly and Company, Indianapolis, IN, USA
P.F. Buckley
Affiliation:
Department of Psychiatry, The Medical College of Georgia, Augusta, GA, USA
L. Citrome
Affiliation:
Department of Psychiatry, New York University, New York, NY, USA

Abstract

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Background

Effectiveness of medication treatment is determined by three components: treatment efficacy (symptom reduction), tolerability/safety, and adherence. Compared with efficacy and safety, research into adherence has been lacking. Nevertheless, medication non-adherence is a risk factor for relapse and for aggressive behavior in association with substance abuse in schizophrenia patients. Non-adherence has been estimated to cause approximately 40% of relapses in patients with schizophrenia. High rates of treatment discontinuation in all arms of the CATIE study illustrate the widespread nature of non-adherence. Most of previous research has defined non-adherence as a complete discontinuation of medication. However, many schizophrenia patients show partial adherence: they do not completely discontinue their medication, but they do not take all that has been prescribed. Partial adherence is more difficult to define and study than complete non-adherence.

Methods

e had the opportunity to study partial adherence in the context of a randomized, double-blind, 8-week, fixed-dose study comparing olanzapine 10mg/d, 20 mg/d and 40 mg/d for patients with schizophrenia or schizoaffective disorder (N=599). Medication non-adherence was measured by pill counts. Baseline characteristics including demographics, illness history and symptom severity were investigated as potential risk factors for treatment non-adherence.

Results and conclusion

Approximately 1/3 of patients were non-adherent with their medication at least once during the 8-week study. These non-adherent patients had significantly less improvement compared to adherent patients. Adherent patients had greater weight gain than the non-adherent ones. Among the available baseline measures, greater baseline depression severity appeared to be a significant risk factor for non-adherence.

Type
S34. Symposium: Long Term Treatment of Schizophrenia
Information
European Psychiatry , Volume 22 , Issue S1: 15th AEP Congress - Abstract book - 15th AEP Congress , March 2007 , pp. S54 - S55
Copyright
Copyright © European Psychiatric Association 2007
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