September 20, 2004

Factors Affecting Med Adherance

A recent study from Innsbruck University Clinics in Austria surveyed 61 patients with schizophrenia, to determine the subjective attitudes and concerns that affect their adherance or non-adherance to medication treatment.

The study concentrated on analyzing four variables: the influence of patient attitude, the influence of clinicians/relatives inquiring about medication adherance, psychopathology, and side effects.

Results showed that patients were most likely to adhere to mediction if: the drugs were percieved as having a positive effect on everyday life, psychiatrists enquired about drug intake, and psychological side effects were present.

The first two variables make sense - clearly, a person is more likely to comply with medication if they can percieve its benefits in their daily lives. The second factor highlights the important role that family and physicians play in the long-term treatment plan. Patients who have people asking about their medication intake seem to adhere better than those who lack this kind of support.

The third variable correlated with medication adherance - the presence of psychological side effects - seems very counter-intuitive. However, the study points out that subjects in the study were surveyed only for the presence of side effects - it makes sense that patients who regularly take their medications are more likely to have such side effects.

The study concludes: "our findings re-emphasize the importance of taking subjective attitudes and concerns of patients seriously and including patients, and, if possible, their significant others, into the treatment decision process."
It seems that a good first step for a family member concerned about a loved one's adherance (or lack thereof) to their medications might be to have an open and honest communication about the issue. Many of the most common reasons for medication non-adherance - side effects, difficulty remembering, the complexity of many medications, the stigma of taking them in public - can be addressed with help from the treating psychiatrist and/or a little creative problem-solving.

For more ideas on how to deal with medication non-compliance (particularly if it is caused by lack of insight on the part of the person with schizophrenia), see Dr. Xavior Amador's book "I Am Not Sick! I Don't Need Help!"

For the full article, see "Variables predicting antipsychotic treatment adherance revealed" (Sept 17, 2004). Available from PsychiatrySource (


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