Family support predicts psychiatric medication usage among Mexican American individuals with schizophrenia

García, Jorge I. Ramírez; Chang, Christina; Young, Joshua S.; López, Steven R.; Jenkins, Janis H.

doi:10.1007/s00127-006-0069-8

Cited by 59 publications

(34 citation statements)

References 28 publications

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“…Study objectives varied, with some focusing specifically on adherence (1, 6, 41, 44–47, 49, 51–60) while others measured adherence as part of studies addressing different questions. Geographically, eight were based in California (6, 42, 43, 47, 48, 50, 54, 55), two in Texas (41, 51), one in New Mexico (52), one in New York (49), one in Connecticut (56), one in Ohio (40), and four were from Veteran’s Administration National Registries (46, 58–60), and three were national studies (1, 45, 57).…”

Section: Resultsmentioning

confidence: 99%

“…One study identified problems with a drug of abuse (45) as a risk factor for nonadherence, however, another study found that abstinence from street drugs (marijuana was excluded from the definition) was not significantly related to adherence (44). …”

Section: Resultsmentioning

confidence: 99%

“…Factors associated with better adherence in individual studies included: greater family instrumental support (task-oriented or hands-on assistance) (44); greater financial support from family (41); more “motivation” (as assessed by coming to appointments, requesting refills when due, asking for medication changes if they felt like their medications were not working) (41); being married (45); having more depressive symptoms (45); taking a serotonin selective reuptake inhibitor (SSRI) as opposed to another type of antidepressant (45); and having made 8 or more visits to a nonmedical therapist (45). …”

Section: Resultsmentioning

confidence: 99%

“…Although studies relying on patient or provider report tend to underestimate nonadherence rates, all studies including only Latinos used patient, family, or provider report to measure adherence, yet surprisingly found higher mean nonadherence rates (44%) than studies using more objective measures (40%). This could be due to some using a combination of patient, family and chart review to assess adherence (43, 44). The higher rates could also be due to differences in study design or patient population, or there could be cultural factors that lead to patient and provider report being more reliable in Latino populations than non-Latino populations.…”

Section: Discussionmentioning

confidence: 99%

“…The results from one study were reported in two different papers (52, 53), so we counted them as one study. One included study (44) examined adherence-related factors in a subset of another (43), so we counted these as one study and used the nonadherence rate reported for the larger sample (43) in our calculation of the mean nonadherence rate of studies including only Latinos. For each of the 21 studies, two authors examined the study design and objectives, the location and patient population, medications studied, participant characteristics (including preferred language of participants and providers, if reported), measures of adherence, rates of adherence overall and by ethnicity, associations between ethnicity and adherence (including statistical measures), and any other adherence-relevant factors identified.…”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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Objective Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. We systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, or mood stabilizer nonadherence among United States (US) Latinos. Methods Data Sources: MEDLINE and PsycINFO were searched using keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms, as well as bibliographies from relevant reviews and studies. Study Selection: 21 studies met inclusion criteria: published since 1980 in English or Spanish; measured psychotropic medication nonadherence rates among US Latino adults. Data Abstraction: We examined articles for study design and objective, location, population, medication type, participant demographics, adherence measure, adherence rates, and factors related to adherence. Results and Conclusions In studies including Latinos and other ethnic groups, mean nonadherence rates were 41%, 31%, and 43% among Latinos, Euro-Americans, and African Americans respectively, with an overall effect size of 0.64 between Latinos and Euro-Americans. In studies including only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found Latinos had significantly lower adherence rates than Euro-Americans. Risk factors for nonadherence included being monolingual Spanish speaking, lacking health insurance, experiencing barriers to quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy. Rates of nonadherence to psychotropic medications were higher for Latinos than for Euro-Americans. Further investigation is needed into the potentially modifiable individual and societal level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.

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