TY - JOUR
T1 - Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode
AU - Perkins, Diana O.
AU - Johnson, Jacqueline L.
AU - Hamer, Robert M.
AU - Zipursky, Robert B.
AU - Keefe, Richard S.
AU - Centorrhino, Franca
AU - Green, Alan I.
AU - Glick, Ira B.
AU - Kahn, Rene S.
AU - Sharma, Tonmoy
AU - Tohen, Mauricio
AU - McEvoy, Joseph Patrick
AU - Weiden, Peter J.
AU - Lieberman, Jeffrey A.
AU - Lieberman, Jeffrey A.
AU - Perkins, Diana
AU - Hamer, Robert
AU - Nemeroff, Charles B.
AU - Cohen, Bruce
AU - Centhorrino, Franca
AU - Tollefson, Gary
AU - Sanger, Todd
AU - Tohen, Mauricio
AU - McEvoy, Joseph P.
AU - Kuldau, John
AU - Green, Alan I.
AU - Rothschild, Anthony J.
AU - Patel, Jayendra K.
AU - Gur, Raquel E.
AU - Zipursky, Robert B.
AU - Daskalakis, Zafiris J.
AU - Strakowski, Stephen M.
AU - Glick, Ira B.
AU - De Quardo, John
AU - Kahn, R. S.
AU - Sharma, Tonmoy
AU - Murray, Robin
N1 - Funding Information:
This work was supported by Lilly Research Laboratories and USPHS grants MH01905 (Dr. Perkins) MH00537, MH33127 (Dr. Lieberman), the UNC Mental Health and Neuroscience Clinical Research Center, the North Carolina Foundation of Hope, MH52376 and MH62157 (Dr. Green). This paper was based on results from the study of the Comparative Efficacy and Safety of Atypical and Conventional Antipsychotic Drugs in First-Episode Psychosis by the HGDH Study Group sponsored by Eli Lilly and Company.
PY - 2006/3/1
Y1 - 2006/3/1
N2 - Background: Many patients recovering from a first psychotic episode will discontinue medication against medical advice, even before a 1-year treatment course is completed. Factors associated with treatment adherence in patients with chronic schizophrenia include beliefs about severity of illness and need for treatment, treatment with typical versus atypical antipsychotic and medication side effects. Method: In this 2-year prospective study of 254 patients recovering from a first episode of schizophrenia, schizophreniform, or schizoaffective disorder we examined the relationship between antipsychotic medication non-adherence and patient beliefs about: need for treatment, antipsychotic medication benefits, and negative aspects of antipsychotic medication treatment. We also examined the relationship between medication non-adherence and treatment with either haloperidol or olanzapine, and objective measures of symptom response and side effects. Results: The likelihood of becoming medication non-adherent for 1 week or longer was greater in subjects whose belief in need for treatment was less (HR = 1.75, 95% CI 1.16, 2.65, p = 0.0077) or who believed medications were of low benefit (HR = 2.88, 95 CI 1.79-4.65, p < 0.0001). Subjects randomized to haloperidol were more likely to become medication non-adherent for ≥ 1 week than subjects randomized to olanzapine (HR-1.51, 95% CI 1.01, 2.27, p = 0.045). Conclusion: Beliefs about need for treatment and the benefits of antipsychotic medication may be intervention targets to improve likelihood of long-term medication adherence in patients recovering from a first episode of schizophrenia, schizoaffective, or schizophreniform disorder.
AB - Background: Many patients recovering from a first psychotic episode will discontinue medication against medical advice, even before a 1-year treatment course is completed. Factors associated with treatment adherence in patients with chronic schizophrenia include beliefs about severity of illness and need for treatment, treatment with typical versus atypical antipsychotic and medication side effects. Method: In this 2-year prospective study of 254 patients recovering from a first episode of schizophrenia, schizophreniform, or schizoaffective disorder we examined the relationship between antipsychotic medication non-adherence and patient beliefs about: need for treatment, antipsychotic medication benefits, and negative aspects of antipsychotic medication treatment. We also examined the relationship between medication non-adherence and treatment with either haloperidol or olanzapine, and objective measures of symptom response and side effects. Results: The likelihood of becoming medication non-adherent for 1 week or longer was greater in subjects whose belief in need for treatment was less (HR = 1.75, 95% CI 1.16, 2.65, p = 0.0077) or who believed medications were of low benefit (HR = 2.88, 95 CI 1.79-4.65, p < 0.0001). Subjects randomized to haloperidol were more likely to become medication non-adherent for ≥ 1 week than subjects randomized to olanzapine (HR-1.51, 95% CI 1.01, 2.27, p = 0.045). Conclusion: Beliefs about need for treatment and the benefits of antipsychotic medication may be intervention targets to improve likelihood of long-term medication adherence in patients recovering from a first episode of schizophrenia, schizoaffective, or schizophreniform disorder.
KW - Adherence
KW - Compliance
KW - First episode
KW - HBM1
KW - Health belief model
KW - Schizophrenia
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U2 - 10.1016/j.schres.2005.10.016
DO - 10.1016/j.schres.2005.10.016
M3 - Article
C2 - 16529910
AN - SCOPUS:33645329854
SN - 0920-9964
VL - 83
SP - 53
EP - 63
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1
ER -
