Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review
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Open Access
- 4 February 2013
- journal article
- research article
- Published by SAGE Publications in Therapeutic Advances in Psychopharmacology
- Vol. 3 (4), 200-218
- https://doi.org/10.1177/2045125312474019
Abstract
Background: Nonadherence to medication is a recognized problem and may be the most challenging aspect of treatment. Methods: 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. A qualitative systematic literature review was conducted using a broad search strategy using disease and adherence terms. Due to the large number of abstracts identified, article selection was based on studies with larger sample sizes published after 2001. Thirty-seven full papers were included: 15 studies on drivers and 22 on consequences, of which 12 assessed the link between nonadherence and hospitalization. Results: Key drivers of nonadherence included lack of insight, medication beliefs and substance abuse. Key consequences of nonadherence included greater risk of relapse, hospitalization and suicide. Factors positively related to adherence were a good therapeutic relationship with physician and perception of benefits of medication. The most frequently reported driver and consequence were lack of insight and greater risk of hospitalization respectively. Conclusions: Improving adherence in schizophrenia may have a considerable positive impact on patients and society. This can be achieved by focusing on the identified multitude of factors driving nonadherence.Keywords
This publication has 47 references indexed in Scilit:
- Dosing frequency and adherence in chronic psychiatric disease: systematic review and meta-analysisNeuropsychiatric Disease and Treatment, 2013
- Low Treatment Adherence with Antipsychotics is Associated with Relapse in Psychotic Disorders within Six Months after DischargePharmacopsychiatry, 2010
- Denial and Acceptance Coping Styles and Medication Adherence in SchizophreniaJournal of Nervous & Mental Disease, 2009
- The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and ElaborationPLoS Medicine, 2009
- The Expert Consensus Guideline SeriesBritish Journal of Psychology, 2009
- Evaluation of noncompliance in schizophrenia patients using electronic monitoring (MEMS®) and its relationship to sociodemographic, clinical and psychopathological variablesSchizophrenia Research, 2009
- Subjective side effects of antipsychotics and medication adherence in people with schizophreniaJournal of Advanced Nursing, 2009
- Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophreniaBMC Psychiatry, 2008
- Outpatient Antipsychotic Treatment and Inpatient Costs of SchizophreniaSchizophrenia Bulletin, 2007
- Religious Beliefs in Schizophrenia: Their Relevance for Adherence to TreatmentSchizophrenia Bulletin, 2007