Medication‐taking behaviours in young adults with schizophrenia: a pilot study

Abstract

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.

A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

“…Data from DoPill ® revealed a mean adherence rate of 67%, which is highly consistent with previous data on MEMS ® (Byerly et al, 2005; Remington, 2008; Acosta et al, 2009; Lee et al, 2011). Additionally, when treated as a dichotomous variable (<70% criteria), 46% of patients were found to be non-adherent using the device.…”

“…The device provided estimates of implementation in FEP patients from the proportion of doses taken on time, which were in accordance with those found in the literature (Diaz et al, 2001; Lacro et al, 2002; Byerly et al, 2005; Remington, 2008; Lee et al, 2011). By contrast, BARS scores were overly optimistic (86–99%) for adherent and non-adherent patients across visits.…”

“…Recently, technologically sophisticated electronic reminder devices and electronic pill dispensers have been developed (Diaz et al, 2001). Among these, the Medication Events Monitoring System (MEMS ® ) has attracted the most interest in the literature (Byerly et al, 2005; Remington, 2008; Acosta et al, 2009; Lee et al, 2011). It consists of a cap containing an electronic chip that records openings of the bottle; the cap contains a liquid crystal display (LCD) screen that shows the number of times the bottle has been opened in the day and hours since its last opening.…”

Understanding treatment non-adherence in schizophrenia and bipolar disorder: a survey of what service users do and why

“…While there are variations in the way in which adherence is defined and measured, and difficulties in obtaining an accurate measurement [1-3], it is estimated that up to half, and possibly more service users with schizophrenia or bipolar disorder do not follow treatment recommendations[3-6]. …”

Primary Caregivers of People with Severe Mental Illness Experience of Anti-Psychotic Medication: Findings from the Semi-Structured Interviews

“…In addition, it poses a risk to alienate medical treatment and look for traditional treatment (i.e. faith healer) to deal with psychiatric illness (H. Lee et al, 2011).…”