Factors Associated with the Effectiveness of a Telephone-Based Nursing Strategy for Enhancing Medication Adherence in Schizophrenia

Abstract

A post hoc analysis was made to identify factors associated with success following a 4-month telephone-based strategy for enhancing adherence to antipsychotic treatment in schizophrenia. A total of 928 stable outpatients were randomized to receive a monthly telephone call provided by a nurse or routine clinical care. Logistic regression with a backward stepwise procedure was used. A higher percentage of patients in the intervention group (25.7%, n=109) improved adherence at the end of the study compared with the control group (16.8%, n=74) (p=0.0013). The intervention was significantly associated with adherence improvement in those patients with a previous negative attitude towards medication (OR=4.7, 95% CI =2.4-9.0, p<0.0001). A slight concordance was obtained between adherence improvement and improvement in patient perception of treatment (kappa=0.21; 95% CI=0.15-0.27). The identification of factors related to the effectiveness of a specific intervention would offer clinicians the opportunity to more adequately select patients who are eligible for such intervention.

Integrative Review of Mobile Phone Contacts and Medication Adherence in Severe Mental Illness

“…A key finding of this review was that mobile phone contacts (text messaging/phone calls) have been used to promote medication adherence in individuals with SMI, and the studies reviewed showed that mobile phone contacts, especially text messages, were effective in reminding study participants to take their medications (Beebe et al, 2008; Beebe et al, 2014; Granholm et al, 2012; Montes et al, 2010; Montes et al, 2012). These results were noted in similar studies (Kunigiri, Gajebasia, & Sallah, 2014; Montes, Maurino, Diez, & Saiz-Ruiz, 2011; Van Gent & Knoppert Van Der Klein, 2010). Moreover, for all the studies reviewed, the use of mobile phone contacts achieved higher medication adherence rates across all the studies.…”

Technological Interventions for Medication Adherence in Adult Mental Health and Substance Use Disorders: A Systematic Review

“…By far, the most commonly collected data were basic psychiatric symptom assessments (A.9.1), for example, early warning signs of psychosis [ 105 ], illicit drug cravings [ 115 ], withdrawal symptoms [ 70 , 90 ], mood [ 107 , 116 ], or PTSD symptoms [ 112 ]. Other studies tracked attitudes toward medication [ 117 ] or medication side effects [ 118 , 119 ] to guide motivational interventions (A.9.2). Others tracked potential triggers or indices for relapse likelihood including stress, anxiety, sleep, and social support [ 42 , 44 , 120 ].…”

Effects of Tele-Nursing Intervention Among Patients With Schizophrenia: An Evidence Based

“…Adherence to antipsychotic treatment was estimated by the treating psychiatrist and the nurse according to the Register of Adherence to Treatment scale (RAT): high (adherence with 80% of doses), moderate (adherence with 60-79% of doses), low (adherence with 20-59% of doses), and nil (adherence with < 20% of doses). In summary, the results of this study detect that a telephone call made by a mental health nurse is a successful intervention for enhancing adherence in stable patients with schizophrenia, especially useful for improving adherence in those patients with a negative attitude towards antipsychotic treatment (Montes et al, 2011).…”