Influencing factors of medication adherence in schizophrenic patients: a meta-analysis

Guo, Jian; Li, Xue; Liu, Na; Kong, Lingling; Qu, Haiying; Yue, Weihua

doi:10.1038/s41537-023-00356-x

Cited by 16 publications

(6 citation statements)

References 64 publications

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“…This is consistent with literature associating medication non-compliance with higher rates of violent and non-violent crimes ( 3 , 22 , 23 ). Medication non-compliance is a common phenomenon in patients with SSD and is even more common in patients with comorbid SUD ( 23 , 24 ). Compliance is influenced by various factors.…”

Section: Discussionmentioning

confidence: 99%

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When do drugs trigger criminal behavior? a machine learning analysis of offenders and non-offenders with schizophrenia and comorbid substance use disorder

Bender,

Machetanz,

von Känel

et al. 2024

Front. Psychiatry

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IntroductionComorbid substance use disorder (SUD) is linked to a higher risk of violence in patients with schizophrenia spectrum disorder (SSD). The objective of this study is to explore the most distinguishing factors between offending and non-offending patients diagnosed with SSD and comorbid SUD using supervised machine learning.MethodsA total of 269 offender patients and 184 non-offender patients, all diagnosed with SSD and SUD, were assessed using supervised machine learning algorithms.ResultsFailures during opening, referring to rule violations during a permitted temporary leave from an inpatient ward or during the opening of an otherwise closed ward, was found to be the most influential distinguishing factor, closely followed by non-compliance with medication (in the psychiatric history). Following in succession were social isolation in the past, no antipsychotics prescribed (in the psychiatric history), and no outpatient psychiatric treatments before the current hospitalization.DiscussionThis research identifies critical factors distinguishing offending patients from non-offending patients with SSD and SUD. Among various risk factors considered in prior research, this study emphasizes treatment-related differences between the groups, indicating the potential for improvement regarding access and maintenance of treatment in this particular population. Further research is warranted to explore the relationship between social isolation and delinquency in this patient population.

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Section: Discussionmentioning

confidence: 99%

“…Compliance is influenced by various factors. They include the medication itself, its dosage and potential side effects, as well as family and social support and patients’ attitudes towards therapy – all of which can impact a patient’s conscious and subconscious willingness to adhere to the prescribed regimen ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

When do drugs trigger criminal behavior? a machine learning analysis of offenders and non-offenders with schizophrenia and comorbid substance use disorder

Bender,

Machetanz,

von Känel

et al. 2024

Front. Psychiatry

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“…A meta-analysis evaluating risk factors of medication noncompliance reported that drug factors, such as poor drug efficacy or high medication side effect response, had the greatest impact on adherence. Furthermore, the severity of the side effects of drugs will lead to patient non-compliant behavior [ 6 ]. Therefore, physicians prescribing antipsychotic medications to patients must be aware of potential side effects, their perceived severity in society, and how to address these challenges to ensure patient compliance.…”

Section: Introductionmentioning

confidence: 99%

A Case of Risperidone-Induced Urinary Incontinence

Eierman,

Reischman,

Gouthro

2024

Cureus

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Schizophrenia spectrum disorders are psychiatric conditions associated with an increased risk of all-cause mortality; patients with these conditions have a shortened average lifespan compared to the general population. First-line treatment for schizophrenia spectrum illness consists of atypical antipsychotics, which are associated with well-understood side effects, including metabolic syndrome, anticholinergic effects, and extrapyramidal symptoms. We are presenting a case of a 36-year-old patient treated with the atypical antipsychotic risperidone who experienced treatment-associated urinary incontinence. In the current literature, atypical antipsychotic-induced urinary incontinence is not well-documented in patients with schizophrenia spectrum disorder. Incontinence is often a topic of societal shame for many patients, and as a side effect, it may influence medication compliance. In the treatment of schizophrenia spectrum disorders, compliance is essential to prevent psychosis relapse in patients, so prescribers must be aware of this potential side effect and how to manage it. Upon a patient presenting with incontinence suspected to be due to atypical antipsychotics, other more common causes of incontinence must first be ruled out. Then, further management can consist of stopping the offending medication or adding a medication to address the incontinence. In this case, our patient had an extended history of suboptimal treated schizoaffective disorder, and risperidone was providing significant improvement; therefore, to ensure continued improvement, we initiated oxybutynin to manage urinary incontinence.

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“…Despite use of these strategies, adherence to antipsychotic medication is only about 42%, with large variation reported in the published literature [ 3 , 6 ]. A recent meta-analysis indicated that drug-related factors, disease factors, problem behavior, low income and quality of life, and personal characteristics appear to be risk factors for medication adherence in people with schizophrenia, while support level, positive attitude, and behavior appear to be protective factors [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Post Hospitalization Clinical Quality Outcomes Among US Patients with Schizophrenia Treated with a Long-Acting Injectable or Switched to a New Oral Antipsychotic: A Retrospective Cohort Study

Patel,

Emont,

Cao

et al. 2023

Drugs - Real World Outcomes

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Background Adherence to antipsychotic medication and care discontinuity remain a challenge to healthcare practitioners providing care to patients with schizophrenia. Objective This study used real-world data from a US hospital-based, all-payer database to examine clinical quality measures among patients with schizophrenia initiated on a long-acting injectable (LAI) or switched to a new oral antipsychotic medication (OAP) following a hospitalization. Methods A retrospective cohort study using the PINC AI™ Healthcare Database compared two cohorts of patients with schizophrenia on post-index hospitalization clinical quality and care continuity endpoints. Patients initiated on an LAI (n = 7292) or switched to a new OAP (n = 31,956) during an index hospitalization between April 2017 and April 2020 were included. Propensity score weighting addressed differences in patient, hospital, and clinical characteristics between the two cohorts. Results Patients who initiated an LAI experienced significantly greater adjusted 30-day antipsychotic medication continuation to index therapy, higher rate of 30-day outpatient follow-up care, longer mean time to discontinuation of index therapy, and lower risk of discontinuing their index treatment compared to patients who switched to a new OAP (all p values < 0.001). Probability of 30-day antipsychotic medication continuation was significantly higher for LAI initiators than for patients who switched to a new OAP, even after controlling for patient, clinical, and hospital characteristics (adjusted odds ratio = 1.2, 95% CI 1.1-1.3, p < 0.001). Conclusion Patients who initiated an LAI in a hospital setting experienced better clinical quality and care continuity outcomes compared to patients who were switched to a new OAP. These findings may be useful in identifying solutions to help improve the quality of medication management post-hospital discharge among patients with schizophrenia. Key PointsPatients with schizophrenia who initiated a long-acting injectable (LAI) demonstrated significantly better clinical quality outcomes following a psychiatric hospitalization compared to oral antipsychotic (OAP) switchers.Despite the high index medication discontinuation rate observed across both treatment groups, more LAI patients were adherent to their medication, stayed on it longer, and were more likely to receive follow-up care within 30 days of hospital discharge compared to OAP switchers.These findings may be useful in identifying solutions to help improve the quality of medication management and care continuity during the critical period between hospitalization and aftercare support.

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Influencing factors of medication adherence in schizophrenic patients: a meta-analysis

Cited by 16 publications

References 64 publications

When do drugs trigger criminal behavior? a machine learning analysis of offenders and non-offenders with schizophrenia and comorbid substance use disorder

When do drugs trigger criminal behavior? a machine learning analysis of offenders and non-offenders with schizophrenia and comorbid substance use disorder

A Case of Risperidone-Induced Urinary Incontinence

Post Hospitalization Clinical Quality Outcomes Among US Patients with Schizophrenia Treated with a Long-Acting Injectable or Switched to a New Oral Antipsychotic: A Retrospective Cohort Study

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