Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T07:15:03.141Z Has data issue: false hasContentIssue false

Strategies for optimizing medication adherence in schizophrenia

Published online by Cambridge University Press:  26 April 2012

Debbi A. Morrissette
Affiliation:
Neuroscience Education Institute, Carlsbad, California, USA
Andrew J. Cutler*
Affiliation:
Florida Clinical Research Center, LLC, Bradenton, Florida, USA
*
*Address correspondence to: Andrew J. Cutler, Courtesy Assistant Professor, Department of Psychiatry, University of Florida, CEO and Chief Medical Officer, Florida Clinical Research Center, LLC, 8043 Cooper Creek Blvd., Suite 107, Bradenton, Florida 34201, USA. Email: [email protected]

Abstract

Medication nonadherence is a common problem in the treatment of schizophrenia. The consequences of nonadherence are numerous and can be quite serious, including increased risk of rehospitalization and suicide. There are numerous factors that affect a patient's decision and ability to take medication, including medication efficacy and tolerability, treatment regimen, cognitive deficits, and the patient's relationship with the treatment team. Fortunately, there are several strategies that may increase treatment adherence, including individualization of medication selection and dosing strategy to maximize efficacy and minimize adverse side effects, utilization of long-acting injectable depot formulations that eliminate the need for the patient to remember daily oral medication, and psychosocial approaches that emphasize the benefits of staying well.

Type
CME Article
Copyright
Copyright © Cambridge University Press 2012

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

1.Lieberman, JA, Stroup, TS, McEvoy, JP, et al. . Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005; 353(12): 12091223.CrossRefGoogle ScholarPubMed
2.Donohoe, G, Owens, N, O'Donnell, C, et al. . Predictors of compliance with neuroleptic medication among inpatients with schizophrenia: a discriminant function analysis. Eur Psychiatry. 2001; 16(5): 293298.CrossRefGoogle ScholarPubMed
3.Lindenmayer, JP, Liu-Seifert, H, Kulkarni, PM, et al. . Medication nonadherence and treatment outcome in patients with schizophrenia or schizoaffective disorder with suboptimal prior response. J Clin Psychiatry. 2009; 70(7): 990996.CrossRefGoogle ScholarPubMed
4.Marder, SR. Overview of partial compliance. J Clin Psychiatry. 2003; 64(suppl 16): 39.Google ScholarPubMed
5.Subotnik, KL, Nuechterlein, KH, Ventura, J, et al. . Risperidone nonadherence and return of positive symptoms in the early course of schizophrenia. Am J Psychiatry. 2011; 168(3): 286292.CrossRefGoogle ScholarPubMed
6.Weiden, PJ, Kozma, C, Grogg, A, Locklear, J. Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatr Serv. 2004; 55(8): 886891.CrossRefGoogle ScholarPubMed
7.Ascher-Svanum, H, Faries, DE, Zhu, B, Ernst, FR, Swartz, MS, Swanson, JW. Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry. 2006; 67(3): 453460.CrossRefGoogle ScholarPubMed
8.Herings, RM, Erkens, JA. Increased suicide attempt rate among patients interrupting use of atypical antipsychotics. Pharmacoepidemiol Drug Saf. 2003; 12(5): 423424.CrossRefGoogle ScholarPubMed
9.Velligan, DI, Diamond, PM, Mintz, J, et al. . The use of individually tailored environmental supports to improve medication adherence and outcomes in schizophrenia. Schizophr Bull. 2008; 34(3): 483493.CrossRefGoogle ScholarPubMed
10.Kruse, GR, Rohland, BM. Factors associated with attendance at a first appointment after discharge from a psychiatric hospital. Psychiatr Serv. 2002; 53(4): 473476.CrossRefGoogle Scholar
11.Compton, MT, Rudisch, BE, Craw, J, Thompson, T, Owens, DA. Predictors of missed first appointments at community mental health centers after psychiatric hospitalization. Psychiatr Serv. 2006; 57(4): 531537.CrossRefGoogle ScholarPubMed
12.Compton, MT, Rudisch, BE, Weiss, PS, West, JC, Kaslow, NJ. Predictors of psychiatrist-reported treatment-compliance problems among patients in routine U.S. psychiatric care. Psychiatry Res. 2005; 137(1–2): 2936.CrossRefGoogle ScholarPubMed
13.Kessler, RC, Berglund, PA, Bruce, ML, et al. . The prevalence and correlates of untreated serious mental illness. Health Serv Res. 2001; 36(6 Pt 1): 9871007.Google ScholarPubMed
14.Robinson, DG, Woerner, MG, Alvir, JM, Bilder, RM, Hinrichsen, GA, Lieberman, JA. Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder. Schizophr Res. 2002; 57(2–3): 209219.CrossRefGoogle ScholarPubMed
15.Pyne, JM, Bean, D, Sullivan, G. Characteristics of patients with schizophrenia who do not believe they are mentally ill. J Nerv Ment Dis. 2001; 189(3): 146153.CrossRefGoogle Scholar
16.Perkins, DO, Gu, H, Weiden, PJ, McEvoy, JP, Hamer, RM, Lieberman, JA. Predictors of treatment discontinuation and medication nonadherence in patients recovering from a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder: a randomized, double-blind, flexible-dose, multicenter study. J Clin Psychiatry. 2008; 69(1): 106113.CrossRefGoogle ScholarPubMed
17.Weiden, PJ. Switching antipsychotics: an updated review with a focus on quetiapine. J Psychopharmacol. 2006. 20(1): 104118.CrossRefGoogle ScholarPubMed
18.Weiden, PJ, Miller, AL. Which side effects really matter? Screening for common and distressing side effects of antipsychotic medications. J Psychiatr Pract. 2001; 7(1): 4147.CrossRefGoogle ScholarPubMed
19.Dolder, CR, Lacro, JP, Dunn, LB, Jeste, DV. Antipsychotic medication adherence: is there a difference between typical and atypical agents? Am J Psychiatry. 2002; 159(1): 103108.CrossRefGoogle Scholar
20.Ritchie, CW, Harrigan, S, Mastwyk, M, Macfarlane, S, Cheesman, N, Ames, D. Predictors of adherence to atypical antipsychotics (risperidone or olanzapine) in older patients with schizophrenia: an open study of 3(1/2) years duration. Int J Geriatr Psychiatry. 2010; 25(4): 411418.CrossRefGoogle Scholar
21.Claxton, AJ, Cramer, J, Pierce, C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001; 23(8): 12961310.CrossRefGoogle ScholarPubMed
22.Pfeiffer, PN, Ganoczy, D, Valenstein, M. Dosing frequency and adherence to antipsychotic medications. Psychiatr Serv. 2008; 59(10): 12071210.CrossRefGoogle ScholarPubMed
23.Mitchell, AJ, Selmes, T. Why don't patients take their medicine? Reasons and solutions in psychiatry. Advances in Psychiatric Treatment. 2007; 13(5): 336346.CrossRefGoogle Scholar
24.Olfson, M, Mechanic, D, Hansell, S, Boyer, CA, Walkup, J, Weiden, PJ. Predicting medication noncompliance after hospital discharge among patients with schizophrenia. Psychiatr Serv. 2000; 51(2): 216222.CrossRefGoogle ScholarPubMed
25.Bhanji, NH, Chouinard, G, Margolese, HC. A review of compliance, depot intramuscular antipsychotics and the new long-acting injectable atypical antipsychotic risperidone in schizophrenia. Eur Neuropsychopharmacol. 2004; 14(2): 8792.CrossRefGoogle ScholarPubMed
26.Green, MF, Kern, RS, Heaton, RK. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res. 2004; 72(1): 4151.CrossRefGoogle ScholarPubMed
27.Milev, P, Ho, BC, Arndt, S, Andreasen, NC. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry. 2005; 162(3): 495506.CrossRefGoogle Scholar
28.Riedel, M, Schennach-Wolff, R, Musil, R, et al. . Neurocognition and its influencing factors in the treatment of schizophrenia-effects of aripiprazole, olanzapine, quetiapine and risperidone. Hum Psychopharmacol. 2010; 25(2): 116125.CrossRefGoogle ScholarPubMed
29.Fleischhacker, WW, Meise, U, Gunther, V, Kurz, M. Compliance with antipsychotic drug treatment: influence of side effects. Acta Psychiatr Scand Suppl. 1994; 382: 1115.Google ScholarPubMed
30.Stahl, SM, Mignon, L. Stahl's Illustrated Antipsychotics: Treating Psychosis, Mania, and Depression, 2nd ed. Cambridge, UK: Cambridge University Press; 2010.CrossRefGoogle Scholar
31.Cutler, A, Ball, S, Stahl, SM. Dosing atypical antipsychotics. CNS Spectr. 2008; 13(5 Suppl 9): 116.CrossRefGoogle ScholarPubMed
32.Gerlach, J. Depot neuroleptics in relapse prevention: advantages and disadvantages. Int Clin Psychopharmacol. 1995; 9(Suppl 5): 1720.CrossRefGoogle ScholarPubMed
33.Gaebel, W, Schreiner, A, Bergmans, P, et al. . Relapse prevention in schizophrenia and schizoaffective disorder with risperidone long-acting injectable vs quetiapine: results of a long-term, open-label, randomized clinical trial. Neuropsychopharmacology. 2010; 35(12): 23672377.CrossRefGoogle ScholarPubMed
34.Kane, JM, Detke, HC, Naber, D, et al. . Olanzapine long-acting injection: a 24-week, randomized, double-blind trial of maintenance treatment in patients with schizophrenia. Am J Psychiatry. 2010; 167(2): 181189.CrossRefGoogle ScholarPubMed
35.Nasrallah, HA, Gopal, S, Gassmann-Mayer, C, et al. . A controlled, evidence-based trial of paliperidone palmitate, a long-acting injectable antipsychotic, in schizophrenia. Neuropsychopharmacology. 2010; 35(10): 20722082.CrossRefGoogle ScholarPubMed
36.Tiihonen, J, Haukka, J, Taylor, M, Haddad, PM, Patel, MX, Korhonen, P. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry. 2011; 168(6): 603609.CrossRefGoogle ScholarPubMed
37.Valenstein, M, Kavanagh, J, Lee, T, et al. . Using a pharmacy-based intervention to improve antipsychotic adherence among patients with serious mental illness. Schizophr Bull. 2011; 37(4): 727736.CrossRefGoogle ScholarPubMed
38.Kemp, R, Kirov, G, Everitt, B, Hayward, P, David, A. Randomised controlled trial of compliance therapy. 18-month follow-up. Br J Psychiatry. 1998; 172: 413419.CrossRefGoogle ScholarPubMed
39.Bush, CT, Langford, MW, Rosen, P, Gott, W. Operation outreach: intensive case management for severely psychiatrically disabled adults. Hosp Community Psychiatry. 1990; 41(6): 647649; discussion 649–651.Google ScholarPubMed
40.Nuechterlein, KH, Green, MF, Kern, RS, et al. . The MATRICS consensus cognitive battery, part 1: test selection, reliability, and validity. Am J Psychiatry. 2008; 165(2): 203213.CrossRefGoogle ScholarPubMed
41.Tandon, R, Belmaker, RH, Gattaz, WF, et al. . World Psychiatric Association Pharmacopsychiatry Section statement on comparative effectiveness of antipsychotics in the treatment of schizophrenia. Schizophr Res. 2008; 100(1–3): 2038.CrossRefGoogle ScholarPubMed
42.McGurk, SR, Twamley, EW, Sitzer, DI, McHugo, GJ, Mueser, KT. A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry. 2007; 164(12): 17911802.CrossRefGoogle ScholarPubMed
43.Penades, R, Catalan, R, Salamero, M, et al. . Cognitive remediation therapy for outpatients with chronic schizophrenia: a controlled and randomized study. Schizophr Res. 2006; 87(1–3): 323331.CrossRefGoogle ScholarPubMed