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 - Jung, Hyun Gang
AU - Kim, Seung Hyun
N1 - Funding Information:
Funding for this study was provided by AstraZeneca. AstraZeneca had no further role in the study design; in the collection, analysis or interpretation of data; in the writing of the manuscript; or in the decision to submit the paper for publication. Its contents are solely the responsibility of the authors.
PY - 2012/2
Y1 - 2012/2
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
U2 - 10.1016/j.schres.2011.11.008
DO - 10.1016/j.schres.2011.11.008
M3 - Article
C2 - 22133906
AN - SCOPUS:84856304513
SN - 0920-9964
VL - 134
SP - 226
EP - 231
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 2-3
ER -
