This article has been cited by other articles in PMC. Nonadherence to medication is a recognized problem and may be the most challenging aspect of treatment. We performed a systematic review of factors that influence adherence and the consequences of nonadherence to the patient, healthcare system and society, in patients with schizophrenia. Particular attention was given to the effect of nonadherence on hospitalization rates, as a key driver of increased costs of care.
Published online Jun Received Jun 2; Accepted Apr The work cannot be changed in any way or used commercially. This article has been cited by other articles in PMC. Abstract Antipsychotics are the drugs prescribed to treat psychotic disorders; however, patients often fail to adhere to their treatment, and this has a severe negative effect on prognosis in these kinds of illnesses.
Among the wide range of risk factors for treatment nonadherence, this systematic review covers those that are most important from the point of view of clinicians and patients and proposes guidelines for addressing them.
Analyzing 38 studies conducted in a total of 51, patients, including patients with schizophrenia spectrum disorders and bipolar disorder, we found that younger age, substance abuse, poor insight, cognitive impairments, low level of education, minority ethnicity, poor therapeutic alliance, experience of barriers to care, high intensity of delusional symptoms and suspiciousness, and low socioeconomic status are the main risk factors for medication nonadherence in both types of disorder.
In the future, prospective studies should be conducted on the use of personalized patient-tailored treatments, taking into account risk factors that may affect each individual, to assess the ability of such approaches to improve adherence and hence prognosis in these patients.
This is determined by various different factors such as patient tolerance of the drug, the appropriateness of the regimen, 1 and, above all, adherence to the treatment prescribed. The best medication at the best dose can never be effective if the patient does not take it.
The objectives of this systematic review are to provide a detailed and comprehensive description of the most important factors associated with lack of adherence to antipsychotic medication in patients with schizophrenia spectrum disorder and bipolar disorder and thereby to contribute to clarify our understanding of the factors underlying nonadherence.
We selected as the start date for the search because of the reintroduction of clozapine in the following decade and the approval of risperidone by the Food and Drug Administration in the same period In addition, we used the following filters: We reviewed all the articles published in English and Spanish.
Subsequently, reference lists from the studies included in our systematic review were hand searched for additional relevant publications. Inclusion Criteria We included all the systematic reviews, meta-analyses, clinical trials, randomized clinical trials, and observational studies in which the study population was patients diagnosed with bipolar disorder, schizophrenia, schizoaffective disorder, or schizophreniform disorder who were being treated with antipsychotics and in whom factors associated with treatment adherence were assessed.
Articles were excluded if patients had a diagnosis other than those mentioned previously or medical treatment with agents other than antipsychotics eg, lithium or mood stabilizersas well as if there was no assessment of factors associated with adherence to treatment with antipsychotics.
Data Collection and Extraction From the set of articles selected in the systematic review, we excluded those that did not meet all the inclusion criteria or met any of the exclusion criteria.
After reading the titles and the abstracts, we selected articles related to the objective of our study. In the event of disagreement, a third researcher analyzed the article independently.
The Basque Office for Health Technology Assessment tool facilitated the assessment of the methodological quality of the research described, classifying it as low, moderate, or high. In this review, we only included high-quality studies. After screening and selection processes, we included 38 articles in this systematic review Fig.
These corresponded to 22 cohort studies, 8 clinical trials, 6 reviews, 1 clinical guideline, and 1 meta-analysis.Objectives: We are examining the effectiveness of a practical, pharmacy-based intervention for improving antipsychotic adherence among patients with serious mental illness (SMI).
Specifically, we are examining whether this pharmacy-based intervention increases antipsychotic medication adherence and patient satisfaction with care and decreases psychiatric symptoms, and inpatient utilization.
· Olivares JM, Alptekin K, Azorin JM, et al. Psychiatrists’ awareness of adherence to antipsychotic medication in patients with schizophrenia: results from a survey conducted across Europe, the Middle East, and ashio-midori.com://ashio-midori.com /overcoming-medication-nonadherence.
Interventions to improve adherence, such as adherence therapy or psychoeducation, produce inconsistent results 8 and are not always effective for patients with schizophrenia.9, 10 One promising intervention is the provision of financial incentives to increase adherence in patients taking antipsychotic ashio-midori.com · for patients with serious mental illness, including schizophrenia, poor adherence to prescribed medication regimens is the most relevant and, at ashio-midori.com Jun 14, · Adherence to antipsychotics by patients diagnosed with psychosis is notably low; a review found a mean rate of 42%.
14 This has negative consequences for patients, their families, and communities. For clinicians, it makes treatment nonadherence one of the most important challenges in treating these highly prevalent psychiatric conditions. · Adherence to Treatment With Antipsychotic Medication and Health Care Costs Among Medicaid Beneficiaries their antipsychotic medications: 24% were nonadherent, 16% were partially ad- herence to treatment with antipsychotic medication in patients with psychotic disorders is a ashio-midori.com