The purpose of this prospective and observational study was to explore medication-taking behaviours in community-based young adults with schizophrenia using an electronic monitoring system and patient self-report questionnaires. The Medication Event Monitoring System (MEMS®), the Index for Medication Adherence (IMA) and the Brief Evaluation of Medication Influences and Beliefs (BEMIB) measured medication-taking behaviours. Data were collected at baseline, 4 and 8 weeks. Descriptive statistics were used in analysis. A total of 11 subjects were recruited; one dropped out. Five were male, and five were female. Average age was 32.64 (SD = 5.70) years. Four (40%) were White people; six (60%) were non-White people. The average number of medications treating schizophrenia was 1.9 (SD = 0.57). MEMS® identified 71.77% (SD = 30.47) dose adherence and 55.92% (SD = 31.27) day adherence. Most subjects took medications irregularly (early, late or missing). The BEMIB demonstrated that 50%, 20% and 30% of subjects considered themselves to be adherent to their medications at baseline, 4 weeks and 8 weeks, while the IMA reported 90%, 90% and 80% at baseline, 4 weeks and 8 weeks, respectively. Regarding the observed discrepancies between patients' reports and their actual medication-taking behaviours, clinical implications were discussed. Effective interventions improving medication adherence in schizophrenia are needed for practice and for future studies.
The purpose of this study was to explore ways of coping and its association with specific stress responses in adolescents with schizophrenia. Additionally, subjects and healthy controls were compared to identify stress responses. Forty subjects were drawn from a self-management therapy study for youth with schizophrenia. Thirty community-dwelling controls were selected. A revised Ways of Coping scale and the Symptom of Stress at baseline, 6, 30 and 54 weeks measured coping and stress response. Descriptive statistics, cluster analysis and Pearson correlation provided data analysis. Thirty-two subjects were male, and eight were female. Average age was 17.25 (SD=1.37) years. Twenty-two (55%) were Caucasian; 18 (45%) were non-Caucasian. Seventeen (57%) of the 30 controls were female. The mean age was 17.10 years old (SD=1.16). Adolescents with schizophrenia used emotion-focused coping more than problem-focused coping at baseline and 6 weeks (P<0.01). Subjects reported higher stress than controls (t=4.73, P<0.01) and used emotion-focused coping with emotional stress responses (r=0.34, P=0.05). Adolescent coping strategies may persist into adulthood unless new skills are introduced. Developing effective coping skills for adolescents with schizophrenia is important for practice and future studies.
BACKGROUND To develop a disease progression model that describes the time course of ACR‐N in RA patients treated with placebo. METHODS Using 536 ACR‐N values from 80 placebo‐treated RA patients enrolled in a 6‐month, randomized, double‐blind study of etanercept, conducted in 13 centers, a disease progression model was developed. Mixture model approach implemented in NONMEM (ver 5.1) was applied with the hybrid estimation method. RESULTS A two normal probability curve model, with each curve multiplied by a coefficient, adequately described the time course of ACR‐N. Based on the multiplication coefficients estimated by mixture model approach, three placebo response groups were identified: no (41.9%), moderate (30.4%) and high (27.7%) responders. Higher baseline value of Health Assessment Questionnaire (BHAQ) significantly decreased the multiplication coefficient of the second curve. Typical patients with BHAQ of 1.7 in the moderate and high responders had early and late peak responses at 4.8 (4.5–5.1) and 19.5 (18.7–20.3) weeks after treatment, respectively. Their ACR‐N values at those peak weeks were 6 (0–12) and 11 (8–15) in the moderate responders, and 25 (2–51) and 65 (54–77) in the high responders, respectively. CONCLUSIONS These results imply that placebo‐treated RA patients show a bi‐modal ACR‐N response pattern with the late peak being higher. Patients with higher BHAQ have lower late ACR‐N. A disease progression model is useful to identify the placebo response pattern in this population. Clinical Pharmacology & Therapeutics (2005) 79, P3–P3; doi:
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