Predictors of adherence to atypical antipsychotics (risperidone or olanzapine) in older patients with schizophrenia: an open study of 3½ years duration

Ritchie, Craig W.; Harrigan, Susy; Mastwyk, Maree; Macfarlane, Stephen; Cheesman, Nevil; Ames, David

doi:10.1002/gps.2354

Cited by 19 publications

(14 citation statements)

References 21 publications

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“…Altogether, we included 63 reports (59 randomized studies) with 45,787 participants (median: 255 participants/study, range: from 12 to 18,154) (Table ). The mean age of the population was 37.6±7.0 years; 62.1±13.3% were male and 61.1±28.8% were white.…”

Section: Resultsmentioning

confidence: 99%

Long‐term effectiveness of oral second‐generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta‐analysis of direct head‐to‐head comparisons

et al. 2019

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Second-generation antipsychotics (SGAs) are recommended for maintenance treatment in schizophrenia. However, comparative long-term effectiveness among SGAs is unclear. Here we provide a systematic review and meta-analysis of randomized trials lasting ≥6 months comparing SGAs head-to-head in schizophrenia and related disorders. The primary outcome was all-cause discontinuation. Secondary outcomes included efficacy and tolerability, i.e., psychopathology, inefficacy-related and intolerability-related discontinuation, relapse, hospitalization, remission, functioning, quality of life, and adverse events. Pooled risk ratio and standardized mean difference were calculated using random-effects models. Across 59 studies (N=45,787), lasting 47.4±32.1 weeks (range 24-186), no consistent superiority of any SGA emerged across efficacy and tolerability outcomes. Regarding all-cause discontinuation, clozapine, olanzapine and risperidone were significantly (p<0.05) superior to several other SGAs, while quetiapine was inferior to several other SGAs. As to psychopathology, clozapine and olanzapine were superior to several other SGAs, while quetiapine and ziprasidone were inferior to several other SGAs. Data for other efficacy outcomes were sparse. Regarding intolerability-related discontinuation, risperidone was superior and clozapine was inferior to several other SGAs. Concerning weight gain, olanzapine was worse than all other compared non-clozapine SGAs, and risperidone was significantly worse than several other SGAs. As to prolactin increase, risperidone and amisulpride were significantly worse than several other SGAs. Regarding parkinsonism, olanzapine was superior to risperidone, without significant differences pertaining to akathisia. Concerning sedation and somnolence, clozapine and quetiapine were significantly worse than some other SGAs. In summary, different long-term SGA efficacy and tolerability patterns emerged. The long-term risk-benefit profiles of specific SGAs need to be tailored to individual patients to optimize maintenance treatment outcomes.

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Section: Resultsmentioning

confidence: 99%

Long‐term effectiveness of oral second‐generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta‐analysis of direct head‐to‐head comparisons

et al. 2019

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“…20 Other studies had also found similar results. [21][22][23][24] However Eticha T et al had observed higher prevalence of treatment adherence in younger schizophrenic patients 25 which can be explained by Dolder CR et al according to whom age had no significant effect on treatment adherence. 26 In the present study 68.4% males and only 59.6% females were non adherent to medications.…”

Section: Observations and Resultsmentioning

confidence: 99%

Non-Adherence to Treatment Among Schizophrenic Patients

Manhas

Akhter

et al. 2019

IJMBS

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Background: One of the frequent problem in schizophrenic patients is non adherence to treatment which can be partial or complete7 and can leads to poor clinical outcomes. Non adherence to antipsychotic medications can lead to increased episodes of violent behavior, exacerbation of psychotic symptoms, increased rates of suicidal/homicidal behavior and resistance to drugs. Aims: To find prevalence of non adherence to treatment in schizophrenic patients. Materials & Methods: This is an observational, cross-sectional study which was conducted over a period of two months, on schizophrenic patients attending the outpatient department (OPD) of tertiary care hospital, Jammu. After meeting inclusion and exclusion criteria, total of 131 patients were selected for the study. Various parameters like age, sex, education, marital status etc were collected. A patient is said to be non adherent if he takes less than 80% of prescribed medication or have gaps in medication of at least 7 days. Results: 64.9% schizophrenic patients were non adherent to their treatment. Prevalence of non adherence was higher in those schizophrenic patients who were males, unmarried, uneducated, unemployed, from rural areas, below 20 years of age and belongs to lower socioeconomic status whereas it was low in those who had parents as their caretakers. Conclusion: In the present study it is concluded that the prevalence of non adherence among schizophrenic patients is high which may hamper treatment outcome, worsens the prognosis of the disease and produces excessive burden on the caretakers of these patients. Hence it is suggested that in addition to providing treatment to these patients, necessary initiatives must be taken by health care professionals to prevent relapses of symptoms by maintaining treatment compliance. Keywords: Non Adherence, Prevalence. Schizophrenia

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“…1,19 For instance, both olanzapine and clozapine may have slightly higher adherence rates compared to risperidone. 20 The complexity of the treatment regimen is also important for adherence; data have shown that number of doses per day is inversely related to adherence. 21,22 More complex regimens may disrupt a patient's daily routine and further compound problems with adherence that are due to memory deficits.…”

Section: Treatment Regimenmentioning

confidence: 99%

Strategies for optimizing medication adherence in schizophrenia

Morrissette

Cutler²

2012

CNS Spectr.

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Medication nonadherence is a common problem in the treatment of schizophrenia. The consequences of nonadherence are numerous and can be quite serious, including increased risk of rehospitalization and suicide. There are numerous factors that affect a patient's decision and ability to take medication, including medication efficacy and tolerability, treatment regimen, cognitive deficits, and the patient's relationship with the treatment team. Fortunately, there are several strategies that may increase treatment adherence, including individualization of medication selection and dosing strategy to maximize efficacy and minimize adverse side effects, utilization of long-acting injectable depot formulations that eliminate the need for the patient to remember daily oral medication, and psychosocial approaches that emphasize the benefits of staying well.

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Predictors of adherence to atypical antipsychotics (risperidone or olanzapine) in older patients with schizophrenia: an open study of 3½ years duration

Cited by 19 publications

References 21 publications

Long‐term effectiveness of oral second‐generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta‐analysis of direct head‐to‐head comparisons

Long‐term effectiveness of oral second‐generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta‐analysis of direct head‐to‐head comparisons

Non-Adherence to Treatment Among Schizophrenic Patients

Strategies for optimizing medication adherence in schizophrenia

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