| Strategies for improving treatment adherence in schizophrenia and schizoaffective disorder. | |
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MedLine Citation:
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PMID: 21190649 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Nonadherence with medication treatment is common but difficult to detect in patients with schizoaffective disorder and schizophrenia, almost half of whom take less than 70% of prescribed doses. Like patients in all areas of medicine, patients with schizoaffective disorder weigh the perceived benefits of medications against perceived disadvantages, but this process is complicated by their impaired insight, the stigma of the diagnosis, and the often troubling side effects of antipsychotic medication. Interventions to improve adherence include encouraging acceptance of the illness, drawing analogies with treatment for chronic medical disease, and involving the patient in decision making. Clinicians must remain nonjudgmental, encouraging patients to disclose problems with adherence and anticipating that improvement in adherence may require a prolonged effort. Selection of antipsychotic medication is critical to avoid adverse side effects, and some medications may provide a sense of well-being, such as improvement in insomnia, anxiety, or depression. Depot (rather than oral) antipsychotics can improve adherence and provide the clinician with reliable information about the dosage of medication received, which can be used for purposes of dose adjustments or to guide response to relapse. |
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Authors:
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Donald C Goff; Michele Hill; Oliver Freudenreich |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: The Journal of clinical psychiatry Volume: 71 Suppl 2 ISSN: 1555-2101 ISO Abbreviation: J Clin Psychiatry Publication Date: 2010 |
Date Detail:
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Created Date: 2010-12-30 Completed Date: 2011-01-31 Revised Date: 2011-03-03 |
Medline Journal Info:
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Nlm Unique ID: 7801243 Medline TA: J Clin Psychiatry Country: United States |
Other Details:
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Languages: eng Pagination: 20-6 Citation Subset: IM |
Copyright Information:
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© Copyright 2010 Physicians Postgraduate Press, Inc. |
Affiliation:
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Schizophrenia Program, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA. goff@psych.mgh.harvard.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antipsychotic Agents
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administration & dosage*,
adverse effects* Anxiety / drug therapy, psychology Chronic Disease Delayed-Action Preparations / administration & dosage Depression / drug therapy, psychology Humans Medication Adherence / psychology Patient Compliance / psychology* Practice Guidelines as Topic Psychotic Disorders / drug therapy*, psychology Schizophrenia / drug therapy* Schizophrenic Psychology Sleep Initiation and Maintenance Disorders / drug therapy, psychology Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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K24 MH002025-10/MH/NIMH NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antipsychotic Agents; 0/Delayed-Action Preparations |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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