Adherence Patterns With First- Versus Second-Generation Antipsychotics for Newly Diagnosed Schizophrenia in Taiwan

Chang, Chia Ming; Wu, Kuan Yi; Liang, Hsin Yi; Wu, Erin Chia Hsuan; Chen, Chuan Yu; Wu, Chi‐Shin; Chen, Shaw Ji; Chang, Tsung Kai; Tsai, Hui Ju

doi:10.1176/appi.ps.201100011

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…Recent research has highlighted nonadherence as a key challenge to psychiatric care in Asia [9–11], Europe [12–14,15 ▪▪ ], South America [16], North America [17 ▪ ,18–20,21 ▪ ], Australia [22], the Middle East [23 ▪ ] and Africa [24 ▪ ]. In Africa, Alene et al [24 ▪ ] evaluated adherence rates to antipsychotic medication in patients receiving care at an Ethiopian hospital.…”

Section: Nonadherence Is a Global Challenge For Psychiatrymentioning

confidence: 99%

“…They identified five groups of patients on the basis of their adherence responses and found that different patterns of adherence were associated with different rates of later discontinuation and hospitalization. Chang et al [9] categorized schizophrenic patients on the basis of type of nonadherence as measured by pharmacy refill and found that different patterns of nonadherence were associated with different antipsychotic drugs. Offord et al [21 ▪ ] found that patients with schizophrenia who had early nonadherence within 90 days of starting a new prescription had lower adherence for the following 12 months.…”

Section: Patterns Of Nonadherence In Psychiatric Disordersmentioning

confidence: 99%

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Medication nonadherence and psychiatry

Chapman

Horne

2013

Current Opinion in Psychiatry

122

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Purpose of reviewNonadherence to appropriately prescribed medication for psychiatric disorders prevents patients from realizing the full benefits of their treatment and negatively impacts on individuals, their families and the healthcare system. Understanding and reducing nonadherence is therefore a key challenge to quality care for patients with psychiatric disorders. This review highlights findings regarding the prevalence and consequence of nonadherence, barriers to adherence and new intervention methods from 2012 onwards.Recent findingsRecent research has highlighted that nonadherence is a global challenge for psychiatry and has linked nonadherence to poorer outcomes, including hospital admissions, suicide and mortality. Optimizing medication regimens can reduce nonadherence; however, often a complex interplay of factors affects individuals’ motivation and ability to follow their prescription. Psychiatrists can enable patients to develop an accurate model of their illness and treatment and facilitate adherence. However, nonadherence is often a hidden issue within consultations. Novel interventions using new technologies and tailoring techniques may have the potential to reduce nonadherence.SummaryNonadherence remains a significant challenge for patients with psychiatric disorders, physicians and healthcare systems. New developments demonstrate the importance of developing tailored interventions to enable patients to overcome perceptual and practical barriers to adherence.

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Section: Nonadherence Is a Global Challenge For Psychiatrymentioning

confidence: 99%

Section: Patterns Of Nonadherence In Psychiatric Disordersmentioning

confidence: 99%

Medication nonadherence and psychiatry

Chapman

Horne

2013

Current Opinion in Psychiatry

122

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“…Non-adherence to antipsychotic medication in schizophrenic patients has also been considered to be a crucial contributor to symptom relapse and poorer long-term outcomes [ 5 – 7 ]. However, it is common for patients with schizophrenia to have low adherence to antipsychotics [ 8 – 10 ] and it had been reported that almost half of schizophrenic patients took less than 70% of the expected prescribed doses [ 11 ]. The risk factors for treatment non-adherence include poor therapeutic response, adverse events related to antipsychotic medication, impaired insight, comorbid substance abuse, negative attitude towards treatment, and dosing frequency and complexity [ 11 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of once-daily quetiapine extended release in patients with schizophrenia switched from other antipsychotics: an open-label study in Chinese population

2015

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BackgroundNon-adherence to antipsychotic medication in schizophrenic patients is common and associated with symptom relapse and poorer long-term outcomes. The risk factors for treatment non-adherence include dosing frequency and complexity. Besides, slower dose titration in an acute schizophrenic episode may lead to attenuated efficacy. Therefore, the convenient dosage regimen and rapid initiation scheme of quetiapine extended release (XR) were expected to provide better effectiveness and promote adherence in patients with schizophrenia. This study was implemented to assess the efficacy and safety of once-daily quetiapine XR in schizophrenic patients with switched from other antipsychotics which were suboptimal due to insufficient efficacy or tolerability.MethodsThis was a 12-week, open-label study conducted in the Chinese population in Taiwan.Patients who had a score of 4 (moderate) or greater on any of the 7 items of the Positive and Negative Syndrome Scale (PANSS) Positive Symptom Subscale and needed to switch from previous antipsychotics were recruited. Quetiapine XR was administered at 300 mg on day 1, 600 mg on day 2 and up to 800 mg after day 2. From day 8 until the end of the study, the dose of quetiapine XR was adjusted within 400-800 mg per day, depending on the clinical response and tolerance of the patients. The variable of the primary outcome was the change from baseline to Week 12 in PANSS total and subscale scores. Secondary outcome was the baseline-to-endpoint difference in the Clinical Global Impression-Severity (CGI-S) scores of the participants.ResultsSixty-one patients were recruited and 55.7% of them completed the study. The mean changes in the PANSS total score and CGI-S score showed significant improvement (−18.4, p < .001 and −1.0, p < .001, respectively). Four patients (6.7%) experienced adverse events including headache, exacerbation of psychosis and dysuria. The use of concomitant anticholinergics decreased from 15.0% to 8.3%.ConclusionsThe results of our investigation implicated that quetiapine XR was an effective and well tolerated alternative for Chinese schizophrenic patients with previous suboptimal treatment. Future large-scale studies are warranted to validate our results.Trial registrationClinicalTrials.gov ID NCT02142556. Registered 15 May 2014.

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“…The formulation of the drugs or route of administration has also been implicated in non-adherence [22], however there was no significant difference in the adherence scores between patients who had long-acting injectables and the general patient population. Also, adherence can be influenced by the generation of drugs being used (first versus second generation antipsychotics) [23]; this relationship could not be fully explored in our study because of the relatively small number of patients who had newer anti-psychotics prescribed. Among other factors that could affect adherence, inadequate information about disease condition and its treatment was common among our study participants.…”

Section: Figure 1: Diagnoses Of the Patientsmentioning

confidence: 99%

Medication Adherence and Patients Satisfaction among Psychiatric Outpatients in a Rural Nigerian Tertiary Healthcare Facility

Fadare¹

2014

J Psychiatry

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Introduction Adherence in mental disorders is a bit different from that in other medical conditions because of some peculiarities associated with these disorders. A major factor that may contribute to non-adherence is the satisfaction or otherwise of the patients to the treatment being received from the health care provider. The main objective of this study was to determine the level of adherence and treatment satisfaction among psychiatric patients in a rural healthcare facility in SouthWest Nigeria. Methods This cross-sectional study used the 8-item Morisky Medication Adherence Scale (MMAS-8) and the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4) to assess the adherence and patient satisfaction respectively. Results A total of 100 patients participated in the study out of which 57 (57%) were males and 43 (43.%) female with a mean age was 37 ± 12.8years. Schizophrenia was the most common diagnosis (67%) found among the study participants. Forty-five (45.9%) patients scored high for adherence, 34 (34.7%) had medium score while 19 (20.4%) scored low. Among patients with schizophrenia, 23 (39%) had high adherence, 26 (44.1%) medium and 10 (16.9%) low adherence. The scoring of the Treatment Satisfaction Questionnaire administered to the patients was done according to the interpretation key. The mean Effectiveness Score was 74.3 ± 15.6, Side-Effects (86.6 ± 24.4), Convenience (73.1 ± 12.8) and Satisfaction (73.5 ±15.7). The mean satisfaction score of patients with schizophrenia was 73.5 ± 14.8 while the score for all other diagnoses (grouped as one) was 74.4 ± 16.5. Conclusion Medication Adherence and Treatment Satisfaction among psychiatric outpatients in a rural Nigerian hospital is good. There is however a need to sustain and even improve on this outcome through better therapeutic alliance with patients and education on the nature of adverse drug reactions to prescribed drugs.

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Adherence Patterns With First- Versus Second-Generation Antipsychotics for Newly Diagnosed Schizophrenia in Taiwan

Abstract: The data substantiated previous observations of the magnitude of adherence problems in Asian populations and highlight the importance of developing new strategies for intervention.

Cited by 8 publications

References 15 publications

Medication nonadherence and psychiatry

Medication nonadherence and psychiatry

The efficacy and safety of once-daily quetiapine extended release in patients with schizophrenia switched from other antipsychotics: an open-label study in Chinese population

Medication Adherence and Patients Satisfaction among Psychiatric Outpatients in a Rural Nigerian Tertiary Healthcare Facility

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