Low Treatment Adherence with Antipsychotics is Associated with Relapse in Psychotic Disorders within Six Months after Discharge

Abstract

Objective: The aim of this study was to assess the association between treatment adherence with antipsychotics and schizophrenia relapse on a continuous scale.

Method: A cohort study with a total of 477 patients with schizophrenia who were recently discharged from an inpatient clinic was performed.

Results: In the 160 people who relapsed within the six months after discharge the average medication possession ratio was 0.50. This was 0.59 in the 317 persons who were not readmitted. The resulting hazard ratio for the medication possession ratio on relapse risk was 0.60 (95% confidence interval: 0.42–0.88).

Conclusion: The found hazard ratio indicates that the risk of relapse is substantially decreased when a patient is properly adherent to the antipsychotic therapy that was prescribed at the inpatient clinic.

References

• 1 dosReis S, Johnson E, Steinwachs D. et al . Antipsychotic treatment patterns and hospitalizations among adults with schizophrenia.  Schizophr Res. 2008;  101 304-311
• 2 Freedman R. Schizophrenia.  N Engl J Med. 2003;  349 1738-1749
• 3 Law MR, Soumerai SB, Ross-Degnan D. et al . A longitudinal study of medication nonadherence and hospitalization risk in schizophrenia.  J Clin Psychiatry. 2008;  69 47-53
• 4 Morken G, Widen J, Grawe R. Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia.  BMC Psychiatry. 2008;  8 32
• 5 Muller N. Mechanisms of relapse prevention in schizophrenia.  Pharmacopsychiatry. 2004;  37 (S 02) 141-147
• 6 Ohmori T, Ito K, Abekawa T. et al . Psychotic relapse and maintenance therapy in paranoid schizophrenia: a 15 year follow up.  Eur Arch Psychiatry Clin Neurosci. 1999;  249 73-78
• 7 Osterberg L, Blaschke T. Adherence to medication.  N Engl J Med. 2005;  353 487-497
• 8 Rajkumar S, Thara R. Factors affecting relapse in schizophrenia.  Schizophrenia Res. 1989;  2 403-409
• 9 Rosen K, Garety P. predicting recovery from schizophrenia: a retrospective comparison of characteristics at onset of people with single and multiple episodes.  Schizophr Bull. 2005;  31 735-750
• 10 Simpson SH, Eurich DT, Majumdar SR. et al . A meta-analysis of the association between adherence to drug therapy and mortality.  BMJ. 2006;  333 15
• 11 Steiner JF, Prochazka AV. The assessment of refill compliance using pharmacy records: Methods, validity, and applications.  J Clin Epidemiol. 1997;  50 105-116
• 12 Weiden PJ, Kozma C, Grogg A. et al . Partial compliance and risk of rehospitalization among california medicaid patients with schizophrenia.  Psychiatr Serv. 2004;  55 886-891
• 13 WHO Collaborating Centre for Drug Statistics Methodology . ATC/DDD Index 2008.  Internet 2008 July 29; available from: URL: http://www.whocc.no/atcddd/
• 14 Wiersma D, Nienhuis FJ, Slooff CJ. et al . Natural course of schizophrenic disorders: a 15-year follow-up of a Dutch incidence cohort.  Schizophr Bull. 1998;  24 75-85

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