Characteristics associated with self-reported medication adherence in persons with psychosis referred to psychosocial rehabilitation centers

Verdoux, Hélène; Quilès, Clélia; Bon, Laura; Chéreau-Boudet, I.; Dubreucq, Julien; Legros-Lafarge, Émilie; Guillard-Bouhet, Nathalie; Massoubre, Catherine; Plasse, Julien; Franck, Nicolás

doi:10.1007/s00406-020-01207-x

Cited by 17 publications

(12 citation statements)

References 55 publications

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“…Fourth, besides their positive effects on symptoms control, antipsychotics and concomitant medications may induce adverse effects, that might seriously affect patient's general health, favor negative attitudes toward treatment and, consequently, lead to a reduction in the treatment adherence, thus compromising the efficacy of an integrated treatment ( 38 , 76 – 79 , 89 , 116 ). Given the presence of differences across the available drugs in terms of individual response and tolerability, the characterization of the individual patient with respect to psychopathological dimensions, physical health and comorbidities should guide the treatment choice ( 6 , 271 , 272 ).…”

Section: Discussionmentioning

confidence: 99%

“…Besides being poorly tolerated by the patient, the presence of side effects seriously affects patient's general health, is associated with less favorable attitudes toward antipsychotic treatments and, consequently, leads to a reduction in adherence to treatment, thus compromising the efficacy of an integrated treatment ( 38 , 76 , 89 , 116 ).…”

Section: Pharmacotherapymentioning

confidence: 99%

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Factors influencing the outcome of integrated therapy approach in schizophrenia: A narrative review of the literature

Giordano

Brando²,

Pezzella³

et al. 2022

Front. Psychiatry

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The integration of pharmacotherapy with psychosocial interventions has an important role to play in the improvement of functional outcome of subjects with schizophrenia (SCZ), in all stages of the disorder. It is essential for the adequate management of unmet therapeutic needs, such as negative symptoms and cognitive dysfunctions which account for most of the functional impairment of subjects with SCZ and do not respond to available antipsychotics. Enhancing the knowledge on factors involved in the effectiveness of integrated treatment plans is an important step forward for SCZ care. This review aims to identify factors that might influence the impact of integrated treatments on functional outcome. Most studies on the impact of psychosocial treatments on functional outcome of subjects with SCZ did not control for the effect of prescribed antipsychotics or concomitant medications. However, several factors relevant to ongoing pharmacological treatment might influence the outcome of integrated therapy, with an impact on the adherence to treatment (e.g., therapeutic alliance and polypharmacotherapy) or on illness-related factors addressed by the psychosocial interventions (e.g., cognitive dysfunctions or motivational deficits). Indirect evidence suggests that treatment integration should consider the possible detrimental effects of different antipsychotics or concomitant medications on cognitive functions, as well as on secondary negative symptoms. Cognitive dysfunctions can interfere with participation to an integrated treatment plan and can be worsened by extrapyramidal or metabolic side effects of antipsychotics, or concomitant treatment with anticholinergics or benzodiazepines. Secondary negative symptoms, due to positive symptoms, sedation, extrapyramidal side effects or untreated depression, might cause early drop-out and poor adherence to treatment. Researchers and clinicians should examine all the above-mentioned factors and implement appropriate and personalized integrated treatments to improve the outcome of SCZ.

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Section: Discussionmentioning

confidence: 99%

Section: Pharmacotherapymentioning

confidence: 99%

Factors influencing the outcome of integrated therapy approach in schizophrenia: A narrative review of the literature

Giordano

Brando²,

Pezzella³

et al. 2022

Front. Psychiatry

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“…The MARS is a 10-item self-administered questionnaire designed to be simple and easy to complete in any clinical context. It assesses medication adherence behavior (items 1-4), attitude toward taking medication (items 5-8), and negative side effects to psychotropic medication (items 9-10) (Verdoux et al, 2020). Total MARS score ranges between 0 and 10.…”

Section: Evaluation Of the Adherence To The Psychopharmacological Treatmentmentioning

confidence: 99%

“…Adherence is a multidimensional phenomenon influenced by several elements: patient, illness, and treatment related factors, therapeutic alliance and engagement with health services, quality of mental health services, economic and social factors (Buchman-Wildbaum et al,2020;Leclerc et al,2013;Leucht e Heres, 2006;Kane e Correll, 2010;Velligan et al, 2017). In schizophrenia spectrum disorders (SSD) and bipolar disorders (BD), adherence appears to be negatively affected by cannabis (Schoeler et al, 2017), alcohol and substance use (Velligan et al,2017), treatment-related sideeffects (Pompili et al,2013), impaired insight (Novick et al,2015;Kim et al,2020;Velligan et al,2017) cognitive deficits (Velligan et al,2017), internalized stigma (Buchman-Wildbaum et al,2020;Kamaradova et al,2016: Verdoux et al, 2020, lower quality of life (Buchman-Wildbaum et al,2020;Verdoux et al, 2020), stage of recovery, and mental well-being (Verdoux et al, 2020), and higher levels of hostility (Czbor et al,2015;Novick et al,2010). Conversely, it seems to be positively influenced by positive attitudes to medications (Sendt et al,2015), therapeutic alliance (Novick et al,2015;Pompili et al,2013), and family support (Saba et al,2019).…”

Section: Manuscript 1 Introductionmentioning

confidence: 99%

Accuracy of self-reported adherence and therapeutic drug monitoring in a psychiatric emergency ward

Brasso¹,

Cisotto²,

Ghirardini³

et al. 2021

Psychiatry Research

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The aims of the study were: 1) the evaluation of the agreement between therapeutic drug monitoring (TDM) and a self-assessment of adherence to psychopharmacological treatments; 2) the identification of predictors of TDM results. Adherence admitted into a psychiatric emergency service (PES) for a relapse of a schizophrenia spectrum disorder (SSD) or a bipolar disorder (BD; DSM-5) was assessed both directly with TDM and indirectly with a self-reported measure (Medication Adherence Report Scale -MARS-10 items). The agreement between TDM and MARS was evaluated. Fifty-seven patients with SSD and 76 people with BD participated in the study. TDM was in range in about 50% of the global sample. No evidence of an association between MARS total scores and TDM results was found. Sensibility, specificity, positive and negative predictive values of almost all MARS total scores were near to 50%. Smoking was strongly associated with a reduction of TDM results within the reference range. In the BD group, female sex was a predictor of TDM in range. In this clinical setting, self-assessment of adherence is neither reliable nor predictive. Furthermore, smoking is a strong predictor of poor adherence to psychopharmacological therapy.

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“…The level of insight thus seems to be a good predictor of antipsychotic medication adherence, level of functioning, and global clinical outcome at 1-year follow-up [ 25 ]. However, not all studies reach this conclusion [ 33 ]. These contradictory results may be partly explained by the cross-sectional or longitudinal nature of the study design.…”

Section: Introductionmentioning

confidence: 99%

Dynamics between insight and medication adherence in first-episode psychosis: Study of 3-year trajectories

et al. 2022

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Background: While specialized early intervention programs represent the gold standard in terms of optimal management of first episode psychosis (FEP), poor medication adherence remains a predominant unmet need in the treatment of psychosis. In this regard, an interaction between insight and adherence in FEP patients has been hypothesized but has been challenged by multiple pitfalls. Methods: Latent profile analysis and trajectory modelling techniques were used to evaluate insight and adherence of 331 FEP patients engaged at the beginning, middle and end of a three-year specialized early psychosis program. A Bayesian model comparison approach was used to compare scores of clinical, functional and socio-economic outcomes at the end point of the study. Results: Nearly one-third of the patients maintain a high level of insight and adherence during the entire program. At the end of the 3-year follow-up, more than three-quarters of patients are considered adherent to their medication. Patients with low levels of insight and adherence at the beginning of the program improve first in terms of adherence and then of insight. Furthermore, patients with high levels of insight and adherence are most likely to reach functional recovery and to experience an increase in environmental quality of life. Conclusions: Latent FEP subpopulations can be identified based on insight and adherence. Medication adherence was the first variable to improve but a gain in insight possibly plays a role in the reinforcement of adherence.

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Characteristics associated with self-reported medication adherence in persons with psychosis referred to psychosocial rehabilitation centers

Cited by 17 publications

References 55 publications

Factors influencing the outcome of integrated therapy approach in schizophrenia: A narrative review of the literature

Factors influencing the outcome of integrated therapy approach in schizophrenia: A narrative review of the literature

Accuracy of self-reported adherence and therapeutic drug monitoring in a psychiatric emergency ward

Dynamics between insight and medication adherence in first-episode psychosis: Study of 3-year trajectories

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