A survey of the attitudes of chronic psychiatric patients living in the community toward their medication

Abstract

Because non-compliance with antipsychotic drug therapy is both common and associated with a substantially increased risk of acute relapse, depot medication must be preferred for most schizophrenic out-patients. Yet there is a perception that depot medication is unpopular among patients. In the survey of out-patients reported here, the great majority of patients receiving either oral or depot neuroleptics (with or without oral augmentation) would, given a free choice, elect to continue with their present dose form (94% and 87%, respectively). In virtually all cases, the choice of route was made by the treating physician and readily accepted by the patient. These findings suggest that physicians should more often recommend and prescribe depot medication when antipsychotic maintenance therapy is indicated.

Attitudes towards long-acting depot antipsychotics: A survey of patients, relatives and psychiatrists

“…This confirms the finding of Glazer and Kane (1992) that patients mostly reject depot medication due to fear of needles. In this respect, we can not confirm our hypothesis based on previous findings that patients generally have a positive attitude towards depot antipsychotics (Pereira and Pinto, 1997;Walburn et al, 2001). An explanation for this could be that most of these studies assessed the attitudes of patients towards depot antipsychotic treatment in samples that currently received depot medication.…”

“…Furthermore, second-generation long-acting injectable drugs are considered to be associated with high treatment costs (Heres et al, 2006). Studies in which the patient's satisfaction with a method of administering drugs is taken into account show that patients have a positive attitude towards depot medication (Pereira and Pinto, 1997;Walburn et al, 2001;Svedberg et al, 2003). However, most findings included a selection bias because they focused on patients who were compliant with medication or received injections regularly.…”

Treatment adherence

“…33 These misconceptions have been refuted. 36,37 It must be highlighted, though, that conventional depot antipsychotics are associated with an inferior safety profile 38,39 and are less efficacious in managing negative symptoms 38 than atypical depots. As a long-acting atypical depot, Risperdal Consta has the potential to further increase adherence and thereby improve the long-term prognosis of patients with schizophrenia.…”

“…Failure of physicians to establish good rapport with patients may determine much of the effectiveness of care. 37,50 A good therapeutic alliance with a doctor who is enthusiastic about treatment and its outcome will ensure better adherence. 51 The patient's perception of the physician's interest in him or her as a person is the best predictor of adherence, 52 and regular contact is necessary.…”

Adherence and Long-Acting Injectable Antipsychotics in Schizophrenia: An Update

“…There is a popular assumption that LAI are associated with more severe and less-manageable side effects, plus, more importantly, arguably compromise individual decision autonomy and involve an element of coercion (38).…”