Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode

Diana O. Perkins, Jacqueline L. Johnson, Robert M. Hamer, Robert B. Zipursky, Richard S. Keefe, Franca Centorrhino, Alan I. Green, Ira B. Glick, Rene S. Kahn, Tonmoy Sharma, Mauricio Tohen, Joseph Patrick McEvoy, Peter J. Weiden, Jeffrey A. Lieberman, Jeffrey A. Lieberman, Diana Perkins, Robert Hamer, Charles B. Nemeroff, Bruce Cohen, Franca CenthorrinoGary Tollefson, Todd Sanger, Mauricio Tohen, Joseph P. McEvoy, John Kuldau, Alan I. Green, Anthony J. Rothschild, Jayendra K. Patel, Raquel E. Gur, Robert B. Zipursky, Zafiris J. Daskalakis, Stephen M. Strakowski, Ira B. Glick, John De Quardo, R. S. Kahn, Tonmoy Sharma, Robin Murray

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)53-63
Number of pages11
JournalSchizophrenia Research
Volume83
Issue number1
DOIs
StatePublished - Mar 1 2006

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Medication Adherence
Antipsychotic Agents
olanzapine
Psychotic Disorders
Schizophrenia
Therapeutics
Haloperidol
Patient Compliance
Prospective Studies

Keywords

  • Adherence
  • Compliance
  • First episode
  • HBM1
  • Health belief model
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Perkins, D. O., Johnson, J. L., Hamer, R. M., Zipursky, R. B., Keefe, R. S., Centorrhino, F., ... Murray, R. (2006). Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode. Schizophrenia Research, 83(1), 53-63. https://doi.org/10.1016/j.schres.2005.10.016

Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode. / Perkins, Diana O.; Johnson, Jacqueline L.; Hamer, Robert M.; Zipursky, Robert B.; Keefe, Richard S.; Centorrhino, Franca; Green, Alan I.; Glick, Ira B.; Kahn, Rene S.; Sharma, Tonmoy; Tohen, Mauricio; McEvoy, Joseph Patrick; Weiden, Peter J.; Lieberman, Jeffrey A.; Lieberman, Jeffrey A.; Perkins, Diana; Hamer, Robert; Nemeroff, Charles B.; Cohen, Bruce; Centhorrino, Franca; Tollefson, Gary; Sanger, Todd; Tohen, Mauricio; McEvoy, Joseph P.; Kuldau, John; Green, Alan I.; Rothschild, Anthony J.; Patel, Jayendra K.; Gur, Raquel E.; Zipursky, Robert B.; Daskalakis, Zafiris J.; Strakowski, Stephen M.; Glick, Ira B.; De Quardo, John; Kahn, R. S.; Sharma, Tonmoy; Murray, Robin.

In: Schizophrenia Research, Vol. 83, No. 1, 01.03.2006, p. 53-63.

Research output: Contribution to journalArticle

Perkins, DO, Johnson, JL, Hamer, RM, Zipursky, RB, Keefe, RS, Centorrhino, F, Green, AI, Glick, IB, Kahn, RS, Sharma, T, Tohen, M, McEvoy, JP, Weiden, PJ, Lieberman, JA, Lieberman, JA, Perkins, D, Hamer, R, Nemeroff, CB, Cohen, B, Centhorrino, F, Tollefson, G, Sanger, T, Tohen, M, McEvoy, JP, Kuldau, J, Green, AI, Rothschild, AJ, Patel, JK, Gur, RE, Zipursky, RB, Daskalakis, ZJ, Strakowski, SM, Glick, IB, De Quardo, J, Kahn, RS, Sharma, T & Murray, R 2006, 'Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode', Schizophrenia Research, vol. 83, no. 1, pp. 53-63. https://doi.org/10.1016/j.schres.2005.10.016
Perkins, Diana O. ; Johnson, Jacqueline L. ; Hamer, Robert M. ; Zipursky, Robert B. ; Keefe, Richard S. ; Centorrhino, Franca ; Green, Alan I. ; Glick, Ira B. ; Kahn, Rene S. ; Sharma, Tonmoy ; Tohen, Mauricio ; McEvoy, Joseph Patrick ; Weiden, Peter J. ; Lieberman, Jeffrey A. ; Lieberman, Jeffrey A. ; Perkins, Diana ; Hamer, Robert ; Nemeroff, Charles B. ; Cohen, Bruce ; Centhorrino, Franca ; Tollefson, Gary ; Sanger, Todd ; Tohen, Mauricio ; McEvoy, Joseph P. ; Kuldau, John ; Green, Alan I. ; Rothschild, Anthony J. ; Patel, Jayendra K. ; Gur, Raquel E. ; Zipursky, Robert B. ; Daskalakis, Zafiris J. ; Strakowski, Stephen M. ; Glick, Ira B. ; De Quardo, John ; Kahn, R. S. ; Sharma, Tonmoy ; Murray, Robin. / Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode. In: Schizophrenia Research. 2006 ; Vol. 83, No. 1. pp. 53-63.
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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

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.

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KW - Adherence

KW - Compliance

KW - First episode

KW - HBM1

KW - Health belief model

KW - Schizophrenia

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