Treatment Adherence in Patients with Schizophrenia


Authors: L. Ustohalihash2 1,2 1,2
Authors‘ workplace: CEITEC MU, Brno 1;  Psychiatrická klinika LF MU a FN Brno 2
Published in: Cesk Slov Neurol N 2012; 75/108(3): 391-394
Category: Treatment News

Overview

Treatment nonadherence is quite frequent in patients with schizophrenia and represents a se­rious problem. It is, therefore, necessary to monitor adherence and to influence it in a po­­sitive way. Measurement of antipsychotic plasma levels can be done quite precisely. In addition, optimal therapeutic plasma levels of a number of antipsychotic drugs are known. Consequently, measurement of antipsychotic plasma levels is considered to be the most suitable method for adherence monitoring. Of the various factors that contribute to nonadherence, we are able to especially influence those that are associated with physicians and the treatment. These factors include treatment efficacy without unpleasant or potentially dangerous side-effects, monotherapy or, if necessary, combinations of antipsychotics or other drugs based on thorough knowledge of their pharmacokinetics. Patient insight represents another important factor; we should strive to develop patient insights and thus establish the basis for a therapeutic partnership.

Key words:
adherence – schizophrenia – antipsychotics


Sources

1. Llorca PM. Partial compliance in schizophrenia and the impact on patient outcomes. Psychiatry Res 2008; 161(2): 235–247.

2. Vytřísalová M. Adherence k medikamentózní léčbě – známá neznámá. Remedia 2009; 19(3): 225–230.

3. Fleischhacker WW, Oehl MA, Hummer M. Factors influencing compliance in schizophrenia patients. J Clin Psychiatry 2003; 64 (Suppl 16): 10–13.

4. Masopust J, Libiger J, Köhler R, Urban A, Čermáková E. Spokojenost nemocných s léčbou antipsychotiky. Čes a slov Psychiatr 2009; 105(1): 12–19.

5. Češková E. Nové trendy v léčbě schizofrenie. Čes a slov Psychiatr 2005; 101(6): 298–302.

6. Svestka J, Bitter I. Nonadherence to antipsychotic treatment in patients with schizophrenic disorders. Neuro Endocrinol Lett 2007; 28 (Suppl 1): 95–116.

7. Coldham EL, Addington J, Addington D. Medication adherence of individuals with first-episode of psychosis. Acta Psychiatr Scand 2002; 106(4): 286–290.

8. Kamali M, Kelly BD, Clarke E, Browne S, Gervin M, Kinsella A et al. A prospective evaluation of adherence to medication in first-episode schizophrenia. Eur Psychiatry 2006; 21(1): 29–33.

9. Češková E, Přikryl R, Kašpárek T, Kučerová H. Nedostatek náhledu a nonkompliance a jejich vzájemný vztah u schizofrenie. Čes a slov Psychiatr 2007; 103(7): 336–340.

10. Mutsatsa SH, Joyce EM, Hutton SB, Webb E, Gibbins H, Paul S et al. Clinical correlates of early medication adherence: West London first episode schizophrenia study. Acta Psychiatr Scand 2003; 108(6): 439–446.

11. Misdrahi D, Petit M, Blanc O, Bayle F, Llorca PM. The influence of therapeutic alliance and insight on medication adherence in schizophrenia. Nord J Psychiatry 2012; 66(1): 49–54.

12. Velligan DI, Weiden PJ, Sajatovic M, Scott J, Carpenter D, Ross R et al. The expert consensus guidelines series: adherence problems in patients with serious and persistent mental illness. J Clin Psychiatry 2009; 70 (Suppl 4): 1–46.

13. Ascher-Svanum H, Nyhuis AW, Stauffer V, Kinon BJ, Faries DE, Phillips GA et al. Reasons for discontinuation and continuation of antipsychotics in the treatment of schizophrenia from patient and clinician perspectives. Curr Med Res Opin 2010; 26(10): 2403–2410.

14. Bodén R, Brandt L, Kieler H, Andersen M, Reutfors J. Early non-adherence to medication and other risk factors for rehospitalization in schizophrenia and schizoaffective disorder. Schizophr Res 2011; 133(1–3): 36–41.

15. Hor K, Taylor M. Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol 2010; 24 (Suppl 4): 81–90.

16. Kane JM. Treatment adherence and long-term outcomes. CNS Spectr 2007; 12 (10 Suppl 17): 21–26.

17. Velligan D, Francis Lam YW, Glahn DC, Barrett JA, Maples NJ, Ereshefsky L et al. Defining and assessing adherence to oral antipsychotics: a review of the literature. Schizophr Bull 2006; 32(4): 724–742.

18. Yang J, Ko YH, Paik JW, Lee MS, Han C, Joe SH et al. Symptom severity and attitudes toward medication: impacts on adherence in outpatients with schizophrenia. Schizophr Res 2012; 134(2–3): 226–231.

19. Češková E. Schizofrenie a její léčba. 2nd ed. Praha: Maxdorf 2007.

20. Davis JM, Chen N, Glick ID. A meta-analysis of the efficacy of second-generation antipsychotics. Arch Gen Psychiatry 2003; 60(6): 553–564.

21. Mojtabai R, Olfson M. National trends in psychotropic medication polypharmacy in office-based psychiatry. Arch Gen Psychiatry 2010; 67(1): 26–36.

22. Přikryl R. Nejvýznamnější lékové interakce antipsychotik v průběhu věku. Postgraduální medicína 2012; 14(1): 77–82.

23. Conley RR, Kelly DL. Drug-drug interactions associated with second-generation antipsychotics: considerations for clinicians and patients. Psychopharmacol Bull 2007; 40(1): 77–97.

24. Mauri MC, Volonteri LS, Colasanti A, Fiorentini A, De Gaspari IF, Bareggi SR. Clinical pharmacokinetics of atypical antipsychotics. Clin Pharmacokinet 2007; 46(5): 359–388.

25. Kirschbaum KM, Müller MJ, Malevani J, Mobascher A, Burchardt C, Piel M et al. Serum levels of aripiprazole and dehydroaripiprazole, clinical response and side effects. World J Biol Psychiatry 2008; 9(3): 212–218.

26. Beck EM, Cavelti M, Kvrgic S, Kleim B, Vaulth R. Are we addressing the “right stuff” to enhance adherence in schizophrenia? Understanding the role of insight and attitudes towards medication. Schizophr Res 2011; 132(1): 42–49.

27. Motlová L, Holub D. Compliance a adherence: spolupráce při léčbě. Remedia 2005; 15(6): 514–516.

28. Goff DC, Hill M, Freudenreich O. Strategies for improving treatment adherence in schizophrenia and schizoaffective disorder. J Clin Psychiatry 2010; 71 (Suppl 2): 20–26.

29. Velligan DI, Weiden PJ, Sajatovic M, Scott J, Carpenter D, Ross R et al. Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines. J Psychiatr Pract 2010; 16(5): 306–324.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 3

2012 Issue 3

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account