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Systematic review of clinical interventions for reducing treatment non-adherence in psychosis

Published online by Cambridge University Press:  11 October 2011

Michela Nosè  and
Corrado Barbui
Michela Nosè*
Affiliation:
Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Università di Verona, Verona
Corrado Barbui
Affiliation:
Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Università di Verona, Verona
*
Address for correspondence: Dr. M. Nose, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Università di Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10, 37134 Verona. Fax: +39-045-585.871 E-mail: [email protected]
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Summary

Aims - Studies investigating the efficacy of clinical interventions for reducing treatmeni non-adherence have generated contrasting findings, and treatment non-adherence remains very common in clinical practice. This systematic review was carried out to investigate the efficacy of clinical interventions that community psychiatric services can implement to reduce nonadherence in patients with psychosis. Method - Systematic review of randomised clinical trials, controlled clinical trials and observational studies assessing the efficacy of adherence enhancing interventions. Results - Forty-seven studies met the inclusion criteria and were included in this systematic review. Data suitable for re-analysis were reported in 24studies; from the remaining 23 studies, with no data suitable for re-analysis, outcome data were extracted according to what study authors reported. In the group of studies included in the meta-analysis educational andpsychotherapeutic interventions were more effective than usual care in reducing patient non-adherence. The remaining 23 studies reported contrasting findings regarding the efficacy of educational strategies. Case management models improved the adherence in half of studies, while other interventions were effective in the majority of studies reported. Conclusions - Community psychiatric services can arrange effective clinical interventions, backed by scientific evidence, for reducing patient non-adherence.

Keywords

complianceadherencepsychoses
Type
Original Papers
Information
Epidemiology and Psychiatric Sciences , Volume 12 , Issue 4 , December 2003 , pp. 272 - 286
Copyright
Copyright © Cambridge University Press 2003

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References

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Olfson, M., Mechanic, D., Boyer, C.A. & Hansell, S. (1998). Linking inpatients with schizophrenia to outpatient care. Psychiatric Services 49, 911–917.CrossRefGoogle ScholarPubMed
Ran, M. & Xiang, M. (1995). A study of schizophrenic patients' treatment compliance in a rural community. Journal of Mental Health 4, 85–89.CrossRefGoogle Scholar
Robinson, G.L., Gilbertson, A.D. & Littwack, L. (1986). The effects of a psychiatric patient education to medication program on postdischarge compliance. Psychiatry Quaterly 58, 113–118.Google ScholarPubMed
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Shivack, I.M. & Sullivan, C.W. (1989). Use of telephone prompts at an inner-city outpatient clinic. Hospital and Community Psychiatry 40, 851–853.Google ScholarPubMed
Sledge, W.H., Moras, K., Hartley, D. et al. (1990). Effect of time-limited psychotherapy on patient dropout rates. American Journal of Psychiatry 147, 1341–1347.Google ScholarPubMed
Stickney, S.K., Hall, R.C.W. & Gardner, E.R. (1980). The effects of referral procedures on aftercare compliance. Hospital and Community Psychiatry 31, 567–569.Google ScholarPubMed
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Xiang, M., Ran, M. & Li, S. (1994). A controlled evaluation of psychoeducational family intervention in a rural Chinese community. British Journal of Psychiatry 165, 544–548.CrossRefGoogle Scholar
Xiong, W., Phillips, M.E., Hu, X., Wang, R., Aai, Q., Kleinman, J. & Kleinman, A. (1994). Family based intervention for schizophrenic patients in China. A randomised controlled trial. British Journal of Psychiatry 165, 239–247.CrossRefGoogle Scholar
Youssef, F.A. (1984). Adherence to therapy in psychiatric patients: an empirical investigation. International Journal of Nursing Studies 21, 51–57.CrossRefGoogle ScholarPubMed
Zhang, M., Wang, M., Li, J. & Phillips, M.R. (1994). Randomised-Control Trial of family intervention for 78 first episode male schizophrenic patients. British Journal of Psychiatry 165, 96–102.CrossRefGoogle Scholar
Atkinson, J.M., Coia, D.A., Gilmour, W.H., Harper, G. & Harper, J. (1996). The impact of education groups for people with schizophrenia on social functioning and quality of life. British Journal of Psychiatry 168, 666–671.CrossRefGoogle ScholarPubMed
Battle, E.H., Haalliburton, A. & Wallston, K.A. (1982). Self Medication among Psychiatric Patients and adherence after discharge. Journal of Psychosocial Nursing Mental Health Service 20, 21–28.CrossRefGoogle ScholarPubMed
Blake, D.D., Owens, M.D. & Keane, T.M. (1990). Increasing group attendance on a psychiatric unit: an alternating treatments design comparison. Journal of Behavioural Therapy and Experimental Psychiatry 21, 15–20.CrossRefGoogle ScholarPubMed
Boczkowski, J.A., Zeichner, A. & DeSanto, N. (1985). Neuroleptic compliance among schizophrenic outpatients: an intervention outcome report. Journal of Consulting and Clinical Psychology 53, 666–71.CrossRefGoogle ScholarPubMed
Bogin, D.L., Anish, S.S., Taub, H.A. & Kline, G.E. (1984). The effects of a referral co-ordinator on compliance with psychiatric discharge plans. Hospital and Community Psychiatry 35, 702–706.Google Scholar
Bond, G.R., Miller, L.D., Krumwied, R.D. & Ward, R.S. (1988). Assertive case management in three CMHCs: a controlled study. Hospital and Community Psychiatry 39, 411–418.Google ScholarPubMed
Brown, C.S., Wright, R.G. & Christensen, D.B. (1987). Association between type of medication instruction and patient knowledge, side effects and compliance. Hospital and Community Psychiatry 38, 55–60.Google ScholarPubMed
Bush, C.T., Langford, M.W., Rosen, P. & Gott, W. (1990). Operation outreach: intensive case management for severely psychiatrically disabled adults. Hospital and Community Psychiatry 41, 647–649.Google ScholarPubMed
Cassino, T., Spellman, N., Heiman, J., Shupe, J. & Sklebar, H.T. (1987). Invitation to compliance: the prolixin brunch. Journal of Psychosocial Nursing 25, 15–19.Google ScholarPubMed
Cruz, M., Cruz, R.F. & McEldoon, W. (2001). Best practice for managing noncompliance with psychiatric appointments in community-based care. Psychiatric Services 52, 1443–1445.CrossRefGoogle ScholarPubMed
Dixon, L., Weiden, P., Torres, M. & Lehman, A. (1997). Assertive community treatment and medication compliance in the homeless mentally ill. American Journal of Psychiatry 154, 1302–1304.Google ScholarPubMed
Eckman, T.A., Liberman, R.P., Phipps, C.C. & Blair, K.E. (1990). Teaching medication management skills to schizophrenic patients. Journal of Clinical Psychopharmacology 10, 33–8.CrossRefGoogle ScholarPubMed
Guimon, J. (1995). The use of group programs to improve medication compliance in patients with chronic diseases. Patient Education and Counseling 26, 189–193.CrossRefGoogle ScholarPubMed
Hornung, W.P., Kieserg, A., Feldmann, R. & Buchkremer, G. (1996). Psychoeducational training for schizophrenic patients: background, procedure and empirical findings. Patient Education and Counseling, 29, 257–268.CrossRefGoogle ScholarPubMed
Larsen, D.L., Nguyen, T.D., Green, R.S. & Attkisson, C.C. (1983). Enhancing the utilisation of outpatient mental health services. Community Mental Health Journal 19, 305–320.CrossRefGoogle ScholarPubMed
Lowe, R.H. (1983). Responding to “no shows”: some effects of follow up method on community mental health centre attendance patterns. Journal of Consulting and Clinical Psychology 50, 602–603.CrossRefGoogle Scholar
MacPherson, R., Jerrom, B. & Hughes, A. (1996). A controlled study of education about dug treatment in schizophrenia. British Journal of Psychiatry 168, 709–717.CrossRefGoogle Scholar
Merinder, L.B., Viuff, A.G., Laugesen, H.D., Clemmensen, K., Misfelt, S. & Epsensen, B. (1999). Patient and relative education in community psychiatry: a randomised controlled trial regarding its effectiveness. Social Psychiatry and Psychiatric Epidemiology 34, 287–294.CrossRefGoogle ScholarPubMed
O'Donnell, M., Parker, G., Proberts, M., Matthews, R., Fisher, D., Johnson, B. & Hadzi-Pavlovic, D. (1999). A study of client-focused case management and consumer advocacy: the Community and Consumer Service Project. Australian and New Zealand Journal of Psychiatry 33, 684–93.CrossRefGoogle ScholarPubMed
Solomon, P., Draine, J & Mannion, E. (1996). The impact of individualised consultation and group workshop family education interventions in ill relative outcomes. Journal of Nervous and Mental Disease 184, 252–255.Google ScholarPubMed
Streicker, S.K., Amdur, M. & Dincin, J. (1986). Educating patients about psychiatric medications: failure to enhance compliance. Psychosocial Rehabilitation Journal 4, 15–28.CrossRefGoogle Scholar
Phan, T. (1995). Enhancing client adherence to psychotropic medication regiments: a psychosocial nursing approach. International Journal of Psychiatric Nursing Research 2, 147–172.Google Scholar
Trautman, R. & Reagan, J.T. (1983). How to increase revenues through appointment reminders. Hospital Topics 33, 3–4.Google Scholar
Boswell, P.C., Brauzer, B., Postlethwaite, N. & LaRuffa, A. (1983). Improving aftercare patients' compliance with appointments through phone calls and letters. Hospital and Community Psychiatry 34, 358–360.Google ScholarPubMed
Chaplin, R. & Kent, A. (1998). Informing patients about tardive dyskinesia. Controlled trial of patient education. British Journal of Psychiatry 172, 78–81.CrossRefGoogle ScholarPubMed
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