CONTEXT: Evidence-based interventions to improve medication adherence among patients with schizophrenia are lacking. Although family psychoeducation has demonstrated efficacy in improving outcomes in schizophrenia, empirical support for its ability to enhance medication adherence is scarce. OBJECTIVE: To determine whether a culturally adapted, multifamily group (MFG) therapy would increase medication adherence and decrease psychiatric hospitalizations for Spanish-speaking Mexican Americans with schizophrenia. DESIGN: A total of 174 Mexican American adults with schizophrenia-spectrum disorder and their key relatives were studied in a 3-armed, randomized controlled trial of MFG therapy focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months. SETTING:Two community mental health centers in Los Angeles, California. PARTICIPANTS: Patients had a diagnosis of schizophrenia or schizoaffective disorder with a recent exacerbation of psychotic symptoms and nonadherence to medication before enrollment. Intervention Patients participated in 1 of 2 MFGs (MFG-adherence or MFG-standard) or treatment as usual. Groups convened twice monthly in 90-minute sessions for 1 year. MAIN OUTCOME MEASURES: The Treatment Compliance Interview uses multiple sources of information to quantify medication adherence. Computerized records were used to collect information on the use of inpatient resources. RESULTS: At the end of the 1-year treatment, MFG-adherence was associated with higher medication adherence than MFG-standard or treatment as usual only (F = 6.41; P = .003). The MFG-adherence participants had a longer time to first hospitalization (χ(2) = 13.3; P = .001) and were less likely to be hospitalized than those in MFG-standard (χ(2) = 8.2; P = .04) and treatment as usual alone (χ(2) = 11.3; P < .001). Increased adherence accounted for one-third of the overall effect of treatment on the reduced risk for psychiatric hospitalization. CONCLUSION: Multifamily group therapy specifically tailored to improve medication adherence through a focus on the beliefs and attitudes of the target population is associated with improved outcome for Mexican American adults with schizophrenia-spectrum disorders. Trial Registration clinicaltrials.gov Identifier: NCT01125267.
RCT Entities:
CONTEXT: Evidence-based interventions to improve medication adherence among patients with schizophrenia are lacking. Although family psychoeducation has demonstrated efficacy in improving outcomes in schizophrenia, empirical support for its ability to enhance medication adherence is scarce. OBJECTIVE: To determine whether a culturally adapted, multifamily group (MFG) therapy would increase medication adherence and decrease psychiatric hospitalizations for Spanish-speaking Mexican Americans with schizophrenia. DESIGN: A total of 174 Mexican American adults with schizophrenia-spectrum disorder and their key relatives were studied in a 3-armed, randomized controlled trial of MFG therapy focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months. SETTING: Two community mental health centers in Los Angeles, California. PARTICIPANTS: Patients had a diagnosis of schizophrenia or schizoaffective disorder with a recent exacerbation of psychotic symptoms and nonadherence to medication before enrollment. Intervention Patients participated in 1 of 2 MFGs (MFG-adherence or MFG-standard) or treatment as usual. Groups convened twice monthly in 90-minute sessions for 1 year. MAIN OUTCOME MEASURES: The Treatment Compliance Interview uses multiple sources of information to quantify medication adherence. Computerized records were used to collect information on the use of inpatient resources. RESULTS: At the end of the 1-year treatment, MFG-adherence was associated with higher medication adherence than MFG-standard or treatment as usual only (F = 6.41; P = .003). The MFG-adherence participants had a longer time to first hospitalization (χ(2) = 13.3; P = .001) and were less likely to be hospitalized than those in MFG-standard (χ(2) = 8.2; P = .04) and treatment as usual alone (χ(2) = 11.3; P < .001). Increased adherence accounted for one-third of the overall effect of treatment on the reduced risk for psychiatric hospitalization. CONCLUSION: Multifamily group therapy specifically tailored to improve medication adherence through a focus on the beliefs and attitudes of the target population is associated with improved outcome for Mexican American adults with schizophrenia-spectrum disorders. Trial Registration clinicaltrials.gov Identifier: NCT01125267.
Authors: Mercedes Hernandez; Concepción Barrio; Lizbeth Gaona; Paula Helu-Brown; Audrey Hai; Caroline Lim Journal: Community Ment Health J Date: 2018-12-01
Authors: Rachel Nichole Casas; Edlin Gonzales; Eréndira Aldana-Aragón; María Del Carmen Lara-Muñoz; Alex Kopelowicz; Laura Andrews; Steven Regeser López Journal: Psychol Serv Date: 2014-11
Authors: Alex Kopelowicz; Roberto Zarate; Charles J Wallace; Robert Paul Liberman; Steven R Lopez; Jim Mintz Journal: J Consult Clin Psychol Date: 2015-06-01
Authors: Roberto Lewis-Fernández; Neil Krishan Aggarwal; Sofie Bäärnhielm; Hans Rohlof; Laurence J Kirmayer; Mitchell G Weiss; Sushrut Jadhav; Ladson Hinton; Renato D Alarcón; Dinesh Bhugra; Simon Groen; Rob van Dijk; Adil Qureshi; Francisco Collazos; Cécile Rousseau; Luis Caballero; Mar Ramos; Francis Lu Journal: Psychiatry Date: 2014 Impact factor: 2.458
Authors: Mercedes Hernandez; Maria Y Hernandez; Daisy Lopez; Concepción Barrio; Diana Gamez; Steven R López Journal: Early Interv Psychiatry Date: 2019-01-15 Impact factor: 2.732