Symptom severity and attitudes toward medication: Impacts on adherence in outpatients with schizophrenia

Jaewon Yang, Young-Hoon Ko, Jong Woo Paik, Moon-Soo Lee, Changsu Han, Sook Haeng Joe, In Kwa Jung, Hyun-Ghang Jeong, Seung Hyun Kim

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Objective: The primary aim of this study was to compare electronic monitoring with other measures of adherence to antipsychotic medication in outpatients with schizophrenia. The secondary aim of the study was to analyze the relationships between adherence and other clinical parameters. Method: Fifty-one patients diagnosed with schizophrenia were monitored over an eight-week period. Medication adherence was assessed using the Medication Event Monitoring System (MEMS), which is a bottle cap with a microprocessor that records the occurrence and times of bottle opening, patient self-reports, a clinician rating scale, and pill counts. Agreements among adherence measures and the relationships between adherence and other clinical factors were assessed. Results: The rate of non-adherence according to the MEMS was 41.2%, considerably higher than those of pill counting (7.8%), clinician rating scale (7.8%), or self-reporting (25.5%). Excitement, impulse control, and preoccupation symptoms on the Positive and Negative Syndrome Scale (PANSS) were higher in the non-adherent patients than in the adherent patients. The full Drug Attitude Inventory (DAI) score was higher in adherent versus non-adherent patients and the significant other subscale of the Multidimensional Scale of Perceived Social Support score was lower in the adherent patients. The Clinical Global Impression-Severity score was negatively correlated with adherence as measured by the MEMS (r = -0.426, p < 0.05) and DAI scores were positively correlated with adherence according to the MEMS and the clinician rating scale (r = 0.498, p < 0.01 and r = 0.387, p < 0.05). Multivariate analysis showed that PANSS and DAI scores significantly contributed to MEMS adherence. Conclusion: Adherence as measured by the MEMS showed a discrepancy with other measures of adherence in patients with schizophrenia. The severity of disease and attitudes toward medication were related to adherence. Further studies are needed to evaluate the impacts of medication adherence in schizophrenia.

Original languageEnglish
Pages (from-to)226-231
Number of pages6
JournalSchizophrenia Research
Volume134
Issue number2-3
DOIs
Publication statusPublished - 2012 Feb 1

Fingerprint

Schizophrenia
Outpatients
Medication Adherence
Equipment and Supplies
Pharmaceutical Preparations
Microcomputers
Patient Compliance
Social Support
Self Report
Antipsychotic Agents
Multivariate Analysis

Keywords

  • Adherence
  • Attitude
  • Medication Event Monitoring System
  • Schizophrenia
  • Symptom

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Symptom severity and attitudes toward medication : Impacts on adherence in outpatients with schizophrenia. / Yang, Jaewon; Ko, Young-Hoon; Paik, Jong Woo; Lee, Moon-Soo; Han, Changsu; Joe, Sook Haeng; Jung, In Kwa; Jeong, Hyun-Ghang; Kim, Seung Hyun.

In: Schizophrenia Research, Vol. 134, No. 2-3, 01.02.2012, p. 226-231.

Research output: Contribution to journalArticle

@article{965786c166b04adf93d2098a9066003a,
title = "Symptom severity and attitudes toward medication: Impacts on adherence in outpatients with schizophrenia",
abstract = "Objective: The primary aim of this study was to compare electronic monitoring with other measures of adherence to antipsychotic medication in outpatients with schizophrenia. The secondary aim of the study was to analyze the relationships between adherence and other clinical parameters. Method: Fifty-one patients diagnosed with schizophrenia were monitored over an eight-week period. Medication adherence was assessed using the Medication Event Monitoring System (MEMS), which is a bottle cap with a microprocessor that records the occurrence and times of bottle opening, patient self-reports, a clinician rating scale, and pill counts. Agreements among adherence measures and the relationships between adherence and other clinical factors were assessed. Results: The rate of non-adherence according to the MEMS was 41.2{\%}, considerably higher than those of pill counting (7.8{\%}), clinician rating scale (7.8{\%}), or self-reporting (25.5{\%}). Excitement, impulse control, and preoccupation symptoms on the Positive and Negative Syndrome Scale (PANSS) were higher in the non-adherent patients than in the adherent patients. The full Drug Attitude Inventory (DAI) score was higher in adherent versus non-adherent patients and the significant other subscale of the Multidimensional Scale of Perceived Social Support score was lower in the adherent patients. The Clinical Global Impression-Severity score was negatively correlated with adherence as measured by the MEMS (r = -0.426, p < 0.05) and DAI scores were positively correlated with adherence according to the MEMS and the clinician rating scale (r = 0.498, p < 0.01 and r = 0.387, p < 0.05). Multivariate analysis showed that PANSS and DAI scores significantly contributed to MEMS adherence. Conclusion: Adherence as measured by the MEMS showed a discrepancy with other measures of adherence in patients with schizophrenia. The severity of disease and attitudes toward medication were related to adherence. Further studies are needed to evaluate the impacts of medication adherence in schizophrenia.",
keywords = "Adherence, Attitude, Medication Event Monitoring System, Schizophrenia, Symptom",
author = "Jaewon Yang and Young-Hoon Ko and Paik, {Jong Woo} and Moon-Soo Lee and Changsu Han and Joe, {Sook Haeng} and Jung, {In Kwa} and Hyun-Ghang Jeong and Kim, {Seung Hyun}",
year = "2012",
month = "2",
day = "1",
doi = "10.1016/j.schres.2011.11.008",
language = "English",
volume = "134",
pages = "226--231",
journal = "Schizophrenia Research",
issn = "0920-9964",
publisher = "Elsevier",
number = "2-3",

}

TY - JOUR

T1 - Symptom severity and attitudes toward medication

T2 - Impacts on adherence in outpatients with schizophrenia

AU - Yang, Jaewon

AU - Ko, Young-Hoon

AU - Paik, Jong Woo

AU - Lee, Moon-Soo

AU - Han, Changsu

AU - Joe, Sook Haeng

AU - Jung, In Kwa

AU - Jeong, Hyun-Ghang

AU - Kim, Seung Hyun

PY - 2012/2/1

Y1 - 2012/2/1

N2 - Objective: The primary aim of this study was to compare electronic monitoring with other measures of adherence to antipsychotic medication in outpatients with schizophrenia. The secondary aim of the study was to analyze the relationships between adherence and other clinical parameters. Method: Fifty-one patients diagnosed with schizophrenia were monitored over an eight-week period. Medication adherence was assessed using the Medication Event Monitoring System (MEMS), which is a bottle cap with a microprocessor that records the occurrence and times of bottle opening, patient self-reports, a clinician rating scale, and pill counts. Agreements among adherence measures and the relationships between adherence and other clinical factors were assessed. Results: The rate of non-adherence according to the MEMS was 41.2%, considerably higher than those of pill counting (7.8%), clinician rating scale (7.8%), or self-reporting (25.5%). Excitement, impulse control, and preoccupation symptoms on the Positive and Negative Syndrome Scale (PANSS) were higher in the non-adherent patients than in the adherent patients. The full Drug Attitude Inventory (DAI) score was higher in adherent versus non-adherent patients and the significant other subscale of the Multidimensional Scale of Perceived Social Support score was lower in the adherent patients. The Clinical Global Impression-Severity score was negatively correlated with adherence as measured by the MEMS (r = -0.426, p < 0.05) and DAI scores were positively correlated with adherence according to the MEMS and the clinician rating scale (r = 0.498, p < 0.01 and r = 0.387, p < 0.05). Multivariate analysis showed that PANSS and DAI scores significantly contributed to MEMS adherence. Conclusion: Adherence as measured by the MEMS showed a discrepancy with other measures of adherence in patients with schizophrenia. The severity of disease and attitudes toward medication were related to adherence. Further studies are needed to evaluate the impacts of medication adherence in schizophrenia.

AB - Objective: The primary aim of this study was to compare electronic monitoring with other measures of adherence to antipsychotic medication in outpatients with schizophrenia. The secondary aim of the study was to analyze the relationships between adherence and other clinical parameters. Method: Fifty-one patients diagnosed with schizophrenia were monitored over an eight-week period. Medication adherence was assessed using the Medication Event Monitoring System (MEMS), which is a bottle cap with a microprocessor that records the occurrence and times of bottle opening, patient self-reports, a clinician rating scale, and pill counts. Agreements among adherence measures and the relationships between adherence and other clinical factors were assessed. Results: The rate of non-adherence according to the MEMS was 41.2%, considerably higher than those of pill counting (7.8%), clinician rating scale (7.8%), or self-reporting (25.5%). Excitement, impulse control, and preoccupation symptoms on the Positive and Negative Syndrome Scale (PANSS) were higher in the non-adherent patients than in the adherent patients. The full Drug Attitude Inventory (DAI) score was higher in adherent versus non-adherent patients and the significant other subscale of the Multidimensional Scale of Perceived Social Support score was lower in the adherent patients. The Clinical Global Impression-Severity score was negatively correlated with adherence as measured by the MEMS (r = -0.426, p < 0.05) and DAI scores were positively correlated with adherence according to the MEMS and the clinician rating scale (r = 0.498, p < 0.01 and r = 0.387, p < 0.05). Multivariate analysis showed that PANSS and DAI scores significantly contributed to MEMS adherence. Conclusion: Adherence as measured by the MEMS showed a discrepancy with other measures of adherence in patients with schizophrenia. The severity of disease and attitudes toward medication were related to adherence. Further studies are needed to evaluate the impacts of medication adherence in schizophrenia.

KW - Adherence

KW - Attitude

KW - Medication Event Monitoring System

KW - Schizophrenia

KW - Symptom

UR - http://www.scopus.com/inward/record.url?scp=84856304513&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856304513&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2011.11.008

DO - 10.1016/j.schres.2011.11.008

M3 - Article

C2 - 22133906

AN - SCOPUS:84856304513

VL - 134

SP - 226

EP - 231

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

IS - 2-3

ER -