Predicting Adherence to Medications by Hispanics with Schizophrenia

Abstract

Casefile data of 100 male and 93female Hispanics with schizophrenia were analyzed to evaluate the impact on the patient's adherence to medication regimen of biodemographic, social support, and treatment variables, and whether the patient's therapist was also Hispanic and spoke Spanish. Results revealed that older and more motivated patients were more likely to adhere to theirmedication. As predicted, those who had greaterfamily support and who were of higher socioeconomic level were also more likely to adhere. Those whose first therapist was of the same ethnicity as the patient (ie., also Hispanic) were more likely to adhere. No relationship was obtained between adherence and patient's level of acculturation, or the extensiveness of treatment: Adherence was less likely whether the therapist spoke Spanish. Implications of these resultsfor mental health practitioners are discussed

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

“…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). …”

“…Twelve reports (N= 12) investigated nonadherence to antipsychotics (1, 6, 41–43, 46, 49–51, 54, 58, 59), five antidepressants (45, 47, 52, 55, 57), two mood stabilizers (48, 60), and two a combination of these medications (40, 56). Ten studies focused on schizophrenia or schizoaffective disorder (1, 6, 41–43, 49–51, 59), five on depression (45, 47, 52, 55, 57), three on bipolar disorder (48, 58, 60), and three a combination of those diagnoses (40, 54, 56).…”

“…Ten studies focused on schizophrenia or schizoaffective disorder (1, 6, 41–43, 49–51, 59), five on depression (45, 47, 52, 55, 57), three on bipolar disorder (48, 58, 60), and three a combination of those diagnoses (40, 54, 56). …”

“…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).…”