New Tool Identifies Non-Adherence in Schizophrenia Patients

(May 26, 2007) -- According to National Adherence Initiative in Schizophrenia survey, presented at the 160th Annual Meeting of the American Psychiatric Association, a new screening tool can help clinicians identify patients with schizophrenia who are at risk of non-adherence with medication. Non-adherence is when patients fail to take their medication as prescribed by their physician.

Using the new tool, clinicians surveyed more than 13,000 patients and found that poor insight, previous failure to take medication and previous discontinuation of medication are the most common reasons for failing to take medication prescribed for schizophrenia in approximately two out of three patients. 

"It is well known that many patients with schizophrenia fail to take oral antipsychotics as prescribed," said John M Kane, Lead Investigator and Director, NIMH Intervention Research Center in Schizophrenia, Hillside Hospital, New York. "It is important for physicians to have a brief, simple tool to be able to identify these patients in order to consider interventions or other options, such as long-acting injectable forms of antipsychotics, that can help improve adherence by helping the treatment team know when patients are not taking their medication."

Previous studies have shown that less than half of patients with schizophrenia prescribed oral antipsychotics take their medication on a regular basis. This is of particular concern as relapse rates are four times higher in patients that do not adhere to their medication. Furthermore, the financial burden of relapse and re-hospitalization in schizophrenia patients in the United States is estimated at approximately $300 million each year.

"The screening tool provides useful descriptive data about the key factors contributing to non-adherence of patients to medication regimens and shows that patient's lack of insight into their illness, discontinuation of medication on their own and forgetting to take medication are the most common reasons for non compliance," Dr. Kane said. "It is therefore an important and effective new tool in helping to identify non-adherence and can help clinicians to intervene when appropriate."

The screening tool was developed by an advisory board of healthcare providers, including psychiatrists, and representatives from advocacy groups. The aim was to develop a brief tool that could be completed by a member of the treatment team to aid in the identification of non-adherence. The screening tool was assessed in a pilot study involving 134 physicians/clinicians and 309 patients. Based on the pilot results, a final screening tool was developed and administered to 1,522 physicians/clinicians and 13,538 of their patients. The screening tool included eight factors that can be related to non-adherence, including poor insight into illness, forgetting medication, stigma about taking medication, psychotic symptoms, previous discontinuation of medication, recent hospitalization, drug/alcohol abuse, and experiencing side effects. The most common reasons clinicians gave for non-adherence to medication in their patients were poor insight into illness (74%), previous discontinuation of medication on their own (68%), and forgetting to take medication (67%). There were also significant regional differences identified in all risk factors except 'stigma about taking medication' (p<0.05). Clinicians rated patients in the Western region of the U.S. as having a higher rate of alcohol or other drug abuse compared to the Northeast (47% vs 38%) and higher rate of discontinuing medication on their own compared to the other regions (73% in the West vs 67% in other regions) contributing to non-adherence. Poor insight into illness was rated high in contributing to non-adherence throughout all regions varying from 67% to 70%.

The study was sponsored by Janssen L.P. Janssen is exclusively dedicated to mental health and committed to providing new treatment options and tools for clinicians to help treat patients with psychiatric illnesses.

Source: Janssen Pharmaceuticals

Last updated: 05/07

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