Immigrant Families Coping with Schizophrenia Behavioural Family Intervention v. Case Management with a Low-Income Spanish-Speaking Population

Abstract

Sociocultural factors affect responses to different types of intervention. The results did not support earlier findings of a beneficial effect of BFM when applied to a socioculturally diverse population.

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

“…The one study that made cross cultural comparisons identified older age for monolingual Spanish-speaking Latinos and more years of past treatment and fewer depressive symptoms for Euro-Americans as predictive of higher adherence (56). Nonadherence was found to predict worsened illness course in the two studies examining the health-related outcomes of nonadherence (42, 43). …”

“…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). …”

“…Of the seven studies that reported preferred language, the proportion of Spanish-speaking participants ranged from 0–100% (mean 45.7±35.0). Seven studies reported country of origin or ancestry of Latino participants, which was primarily Mexico in four (41, 43, 50, 51), primarily Puerto Rico in two (40, 56), and a mix of Mexico, Guatemala, and El Salvador in one (42). …”

“…Studies used a range of adherence measures including: patient report (50, 55); chart review or physician report (41); a combination of patient and family report and chart review (43, 49); medication discontinuation (by patient report) (45, 47, 57); pill counts of returned pills (46); Medication Event Monitoring System (MEMS) pill bottle caps (56); calculations from pharmacy records (including CMGR, MPR, CPR) (1, 6, 48, 51, 52, 58–60); urine testing for metabolites (54); and not stated (40, 42). Nineteen studies reported the time period used to examine adherence, which ranged from one week to 48 months (mean 10.2months±10.3).…”

“…The fourth explored risk factors for nonadherence in Latinos but did not detail rates and is discussed later (42). Of the 17 studies including Latinos and other ethnic groups (Table 2), 12 (1, 6, 40, 47, 49–52, 56–58, 60) had data available to compare the nonadherence rates between Latinos and Euro-Americans.…”