| A prospective study of risk factors for nonadherence with antipsychotic medication in the treatment of schizophrenia. | |
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MedLine Citation:
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PMID: 16889456 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study aimed to prospectively identify the best single predictor and the best set of predictors of risk for nonadherence with anti-psychotic medication in the treatment of patients with schizophrenia. METHOD: We used data from 1579 patients in a 3-year, prospective, naturalistic, nonrandomized, multisite study of schizophrenia patients conducted from July 1997 to September 2003 (U.S. Schizophrenia Care and Assessment Program). Adherence with any oral antipsychotic medication was assessed using patient-reported medication adherence and an indirect adherence measure based on medical record prescription information. Patients who reported poor medication adherence or had a medication possession ratio < or = 80% (percentage of days with prescriptions for any oral antipsychotic) during the first year after enrollment were defined as nonadherent (N = 296, 18.8%). Thirty-nine previously reported potential risk factors of nonadherence with antipsychotic medication were assessed at enrollment with valid and reliable measures. Risk factors represented patient-, environment-, and treatment-related domains, including sociodemographics, symptom severity, substance use, threat to safety of self and others, other illness-related factors, need for supervision, medication-related adverse events, and prior medication-utilization patterns. RESULTS: The best single predictor of future nonadherence was nonadherence during the 6 months prior to enrollment (odds ratio = 4.1, 95% confidence interval = 3.1 to 5.6, p < .001). The best set of predictors of nonadherence, ordered by strength of association, included prior non-adherence, recent illicit drug use, recent alcohol use, prior treatment with antidepressants, and greater patient-reported, medication-related cognitive impairment. CONCLUSION: Nonadherence with antipsychotic medication is associated with a well-defined set of risk factors that can be used to identify patients who are predisposed to poor adherence. |
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Authors:
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Haya Ascher-Svanum; Baojin Zhu; Douglas Faries; Jonathan P Lacro; Christian R Dolder |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of clinical psychiatry Volume: 67 ISSN: 0160-6689 ISO Abbreviation: J Clin Psychiatry Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-08-07 Completed Date: 2006-08-30 Revised Date: 2006-11-15 |
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: 1114-23 Citation Subset: IM |
Affiliation:
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Eli Lilly and Co., Lilly Corporate Center, Indianapolis, IN 46285, USA. haya@lilly.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Antidepressive Agents / therapeutic use Antipsychotic Agents / administration & dosage, adverse effects, therapeutic use* Cognition Disorders / chemically induced, diagnosis, epidemiology Drug Utilization Female Follow-Up Studies Health Status Humans Longitudinal Studies Male Medical Records / statistics & numerical data Prospective Studies Psychiatric Status Rating Scales / statistics & numerical data Risk Factors Schizophrenia / drug therapy*, epidemiology Schizophrenic Psychology Treatment Refusal / statistics & numerical data* United States |
| Chemical | |
Reg. No./Substance:
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0/Antidepressive Agents; 0/Antipsychotic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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