Medication adherence in psychosis: predictors and impact on outcome.A 2‐year follow‐up of first‐admitted subjects

Verdoux, Hélène; Lengronne, J.; Liraud, F.; Gonzales, B.; Assens, F.; Abalan, F.; Os, Jim van

doi:10.1034/j.1600-0447.2000.102003203.x

Cited by 177 publications

(162 citation statements)

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“…The data are consistent with the literature, even if the prevalence of substance use we found is higher because we included any kind of use and not only categorically defined substance use disorders (Addington and Addington , 2007;Myles et al, 2012;Van Mastrigt et al, 2004). As in many previous studies (Coldham et al, 2002;Levy et al, 2012;Miller et al, 2011;Novak-Grubic and Tavcar, 2002;Verdoux et al, 2000), more than 40% of patients recruited showed poor adherence to their pharmacological treatment during the one year follow-up, but contrary to the published literature, this was not predicted by socio-demographic characteristics (Cotton et al, 2009;Perkins et al, 2008). Our findings are however in line with the previous literature (Alvarez-Jimenez et al, 2012) in showing an increased risk of non-remission due to poor medication adherence.…”

Section: Discussionsupporting

confidence: 82%

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Substance use, medication adherence and outcome one year following a first episode of psychosis

Colizzi

Carra

Fraietta

et al. 2016

Schizophrenia Research

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Substance use, medication adherence and outcome one year following a first episode of psychosis ABSTRACT Both substance use and poor medication adherence are associated with poor outcome in psychosis. To clarify the contributions of substance use and poor medication adherence to poor outcome in the year following a first episode of psychosis, 205 patients were evaluated for use of tobacco, alcohol, cannabis and stimulants at their psychosis onset, and in a 1-year follow-up. Data on medication adherence and symptom remission were also collected. Patients had high rates of overall substance use before (37-65%) and after psychosis onset (45-66%). 44% showed poor medication adherence and 55% did not reach remission from psychosis. Nicotine dependence and cannabis use after psychosis onset significantly predicted both poor medication adherence and nonremission, and poor medication adherence mediated the effects of these substances on nonremission. In conclusion, medication adherence lies on the causal pathway between nicotine dependence and cannabis on the one hand and non-remission on the other.

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Section: Discussionsupporting

confidence: 82%

“…Thus, poor medication adherence in patients following the first episode of psychosis (FEP) is associated with more frequent readmissions (Caseiro et al, 2012;Verdoux et al, 2000), and a greater risk of relapse (Kahn et al, 2008;Malla et al, 2006;NovakGrubic and Tavcar, 2002).…”

Section: Introductionmentioning

confidence: 99%

Substance use, medication adherence and outcome one year following a first episode of psychosis

Colizzi

Carra

Fraietta

et al. 2016

Schizophrenia Research

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“…[1][2][3] Poor adherence is also associated with an increased risk of relapse, 4,5 a higher rate of hospital readmissions, 6 a higher level of residual symptoms, 5 a poorer quality of life, 6 and lower overall functioning. 7 Social support has also been linked to outcome in schizophrenia and related disorders, either directly 8 or through the impact of family-related interventions on symptoms, 9 relapse, 10 social functioning, 9 as well as the number and length of hospitalizations.…”

Section: Limitationsmentioning

confidence: 99%

The Influence of Perceived Social Support on Medication Adherence in First-Episode Psychosis

et al. 2013

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Objective: Our study examines the unique influence of social and family support on adherence to medication in a sample of patients treated for first-episode psychosis (FEP).Method: Social and family support using the Multidimensional Scale of Perceived Social Support and medication adherence (consensus of subjective and objective data) were evaluated on a monthly basis during a 6-month period in a sample of 82 FEP patients. The relation between social support and adherence was evaluated using correlational and linear regression analyses, controlling for other relevant variables. A longitudinal analysis using hierarchical linear models was conducted to model change in adherence over time. Results:Monthly correlations between social support and adherence were significant at 4 of 7 time points during a 6-month period. There was a modest correlation between the percentage of months of good adherence and the average level of family support across the study period. The linear regression failed to demonstrate a significant relation between baseline social support and overall adherence during the entire study period. Change in social support over time was inversely associated with change in adherence. Conclusions:Our study emphasizes the concurrent influence of social (mostly family) support on adherence but this effect does not persist over time. Changes in the degree of social support may have a complex effect on changes in adherence. W W W

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“…5,[8][9][10] Poor adherence has also been associated with an increased risk and rate of relapse, 11,12 increased number of voluntary and involuntary admissions, 13 greater levels of residual positive symptoms, 12 and poor quality of life, 12 social relations, and activities of daily living. 14 Outcome in the early phase of illness may be associated with longer-term global outcome in schizophrenia.…”

mentioning

confidence: 99%

Early Predictors of Nonadherence to Antipsychotic Therapy in First-Episode Psychosis

et al. 2009

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Objective: To examine the hypothesis that poorer social and family support, identifiable at the onset of treatment, is associated with nonadherence in the first 6 months of treatment of patients with first-episode psychosis (FEP), independent of other patient-related factors.Method: Consecutive patients (n = 100) admitted to a specialized early intervention service for FEP who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for either a schizophrenia spectrum disorder or an affective psychosis were evaluated monthly for 6 months regarding their adherence to medications. Using sociodemographic and illness-related factors, including social and family support, as independent variables and adherence as the dependent variable, univariate analyses were followed by logistic regression.Results: Fifty-six patients (54.9%) were adherent (76% to 100% of doses taken) and 46 (45.1%) nonadherent (less than 76% of doses taken). Nonadherent patients were less likely to have received a good level of social support (c 2 = 5.89, df = 1, P = 0.02), as rated by their respective case manager, and more likely to be single (Fisher exact test, P = 0.019) and to have refused medication at the first offer of treatment (c 2 = 19.70, df = 1, P = 0.001). Using logistic regression, both the level of social support (OR = 3.552, P = 0.03) and early medication acceptance (OR = 11.092, P < 0.001) were significant as predictors of adherence. Conclusion Clinical Implications· Social and family support may be an important determinant of adherence to medication very early in the course of treatment of FEP. · Refusal to be treated at the first offer of treatment remains the most likely reason for nonadherence to medication, at least in the first 6 months of treatment of FEP. · Interventions may need to be designed to influence adherence to medication very early in the course of treatment. Limitations· The measure of social and family support used may have been too brief and not able to tap into different aspects of support from family and others in the social environment. · The absence of influence of insight on adherence to medication might have resulted from using the one item from the Positive and Negative Symptom Scale for assessing insight and not using a more detailed measure of insight. · The relatively high level of nonadherence may be a reflection of a very conservative measure of adherence to medication (taking greater than 75% of doses of medication prescribed).

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Medication adherence in psychosis: predictors and impact on outcome.A 2‐year follow‐up of first‐admitted subjects

Cited by 177 publications

References 13 publications

Substance use, medication adherence and outcome one year following a first episode of psychosis

Substance use, medication adherence and outcome one year following a first episode of psychosis

The Influence of Perceived Social Support on Medication Adherence in First-Episode Psychosis

Early Predictors of Nonadherence to Antipsychotic Therapy in First-Episode Psychosis

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