Emile Barkhof1, Carin J Meijer, Leo M J de Sonneville, Don H Linszen, Lieuwe de Haan. 1. *To whom correspondence should be addressed; Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands; tel: 31-20-8913500, fax: 31-20-8913702, e-mail: e.barkhof@amc.uva.nl.
Abstract
BACKGROUND:Medication nonadherence in patients with schizophrenia presents a serious clinical problem. Research on interventions incorporating motivational interviewing (MI) to improve adherence have shown mixed results. AIMS: Primary aim is to determine the effectiveness of a MI intervention on adherence and hospitalization rates in patients, with multi-episode schizophrenia or schizoaffective disorder, who have experienced a psychotic relapse following medication nonadherence. Secondary aim is to evaluate whether MI is more effective in specific subgroups. METHODS: We performed a randomized controlled study including 114 patients who experienced a psychotic relapse due to medication nonadherence in the past year. Participants received an adapted form of MI or an active control intervention, health education (HE). Both interventions consisted of 5-8 sessions, which patients received in adjunction to the care as usual. Patients were assessed at baseline and at 6 and 12 months follow-up. RESULTS: Our results show that MI did not improve medication adherence in previously nonadherent patients who experienced a psychotic relapse. Neither were there significant differences in hospitalization rates at follow-up between MI and HE (27% vs 40%, P = .187). However, MI resulted in reduced hospitalization rates for female patients (9% vs 63%, P = .041), non-cannabis users (20% vs 53%, P = .041), younger patients (14% vs 50%, P = .012), and patients with shorter illness duration (14% vs 42%, P = .040). CONCLUSIONS: Targeted use of MI may be of benefit for improving medication adherence in certain groups of patients, although this needs further examination.
RCT Entities:
BACKGROUND: Medication nonadherence in patients with schizophrenia presents a serious clinical problem. Research on interventions incorporating motivational interviewing (MI) to improve adherence have shown mixed results. AIMS: Primary aim is to determine the effectiveness of a MI intervention on adherence and hospitalization rates in patients, with multi-episode schizophrenia or schizoaffective disorder, who have experienced a psychotic relapse following medication nonadherence. Secondary aim is to evaluate whether MI is more effective in specific subgroups. METHODS: We performed a randomized controlled study including 114 patients who experienced a psychotic relapse due to medication nonadherence in the past year. Participants received an adapted form of MI or an active control intervention, health education (HE). Both interventions consisted of 5-8 sessions, which patients received in adjunction to the care as usual. Patients were assessed at baseline and at 6 and 12 months follow-up. RESULTS: Our results show that MI did not improve medication adherence in previously nonadherent patients who experienced a psychotic relapse. Neither were there significant differences in hospitalization rates at follow-up between MI and HE (27% vs 40%, P = .187). However, MI resulted in reduced hospitalization rates for female patients (9% vs 63%, P = .041), non-cannabis users (20% vs 53%, P = .041), younger patients (14% vs 50%, P = .012), and patients with shorter illness duration (14% vs 42%, P = .040). CONCLUSIONS: Targeted use of MI may be of benefit for improving medication adherence in certain groups of patients, although this needs further examination.
Authors: M Smeerdijk; R Keet; N Dekker; B van Raaij; M Krikke; M Koeter; L de Haan; C Barrowclough; G Schippers; D Linszen Journal: Psychol Med Date: 2011-12-08 Impact factor: 7.723
Authors: Marcia Valenstein; Janet Kavanagh; Todd Lee; Peter Reilly; Gregory W Dalack; John Grabowski; David Smelson; David L Ronis; Dara Ganoczy; Emily Woltmann; Tabitha Metreger; Patricia Wolschon; Agnes Jensen; Barbara Poddig; Frederic C Blow Journal: Schizophr Bull Date: 2009-11-21 Impact factor: 9.306
Authors: Julie Kreyenbuhl; Elizabeth J Record; Seth Himelhoch; Melanie Charlotte; Jessica Palmer-Bacon; Lisa B Dixon; Deborah R Medoff; Lan Li Journal: Clin Schizophr Relat Psychoses Date: 2016-07-25