<p>Drug Attitude, Insight, and Patient’s Knowledge About Prescribed Antipsychotics in Schizophrenia: A Cross-Sectional Survey</p>

Abstract

Introduction: While patients' perspectives toward pharmacotherapy are expected to be directly influenced by their motivation and understanding of the treatment that they are currently receiving, no study has comprehensively investigated the impact of insight into illness and knowledge for the ongoing pharmacotherapy on the attitude towards drug treatment among patients with schizophrenia. Materials and Methods: One hundred forty-eight Japanese outpatients diagnosed with schizophrenia, according to the International Classification of Diseases 10th edition, were included (mean±SD age, 47.3±12.4 years; 90 men (60.8%)). Attitudes toward antipsychotic treatment and insight into illness were assessed with the Drug Attitude Inventory-10 (DAI-10) and the VAGUS, respectively. In addition, a multiple-choice questionnaire that was designed to examine patients' knowledge about therapeutic effects, types, and implicated neurotransmitters of antipsychotic drugs they were receiving was utilized. Results: The mean±SD of DAI-10 score was 4.7±4.2. The multiple regression analysis found that lower Positive and Negative Syndrome Scale (PANSS) scores, higher VAGUS scores, and longer illness duration were significantly associated with higher DAI-10 scores (β=−0.226, P=0.009; β=0.250, P=0.008; β=0.203, P=0.034, respectively). There was a significant difference in the DAI-10 scores between the subjects who gave more accurate answers regarding the effects of their primary antipsychotic and those who did not (mean ±SD, 5.57±4.38 vs 4.13±4.04, P=0.043); however, this finding failed to survive the multiple regression analysis. Conclusion: Better insight into illness and treatment, lower illness severity, longer illness duration, and possibly greater knowledge about the therapeutic effects of medications may lead to better attitudes towards pharmacotherapy among patients with schizophrenia, which has an important implication for this typically chronic mental condition requiring long-term antipsychotic treatment to sustain stability.

Dynamics between insight and medication adherence in first-episode psychosis: Study of 3-year trajectories

“…In this respect, the intensive and recovery centered treatment ideally provided by specialized early intervention programs facilitates the development of a therapeutic relationship [63]. Apart from strategies aimed at improving adherence to medication such as the use of long-acting injectable (LAI) antipsychotics [64,65], motivational interviews, web-based psychoeducation, or SMS medication reminders [66], targeting insight seems to be useful to enhance adherence through a synergic process, which in turn improves outcome [67], particularly in terms of functional recovery. Furthermore, our finding that gain in adherence appears to occur earlier than improvement in insight throughout the program is interesting.…”

“…Finally, patients’ attitudes toward medication were not considered. In this respect, one cross-sectional study looked at the impact of insight into illness and the global knowledge of patients with schizophrenia about their ongoing medication on their attitudes toward drug treatment [ 67 ]. The results concluded that good insight is associated with more favorable attitudes toward antipsychotic medication.…”

Attitude and influencing factors of patients with schizophrenia toward long-acting injections: A community-based cross-sectional investigation in China

“…Furthermore, the attitude toward and willingness to use LAIs of community-based patients with schizophrenia will also be affected by the characteristics of family monitoring and the coexistence of disease outcome ( 30 , 31 ). Our study showed that patients' age, marital status, care ability, outpatient adherence, antipsychotic adherence, and attitude toward oral antipsychotics were important predictor of patients' attitudes toward LAI antipsychotics.…”

A scoping review: Treatment attitudes and adherence for adults with schizophrenia

“…Social and environmental factors such as relationship with clinicians, living situation and stigma of the illness, influence adherence at both consumer and service levels. There is a growing number of review papers on adherence; however, these reviews have given little attention to the impact of attitudes towards medication and adherence in people experiencing schizophrenia (Nagai et al, 2020). This population experiences higher medication non-adherence incidence rates (Xu et al, 2018).…”

“…In addition, the development of effective interventions to improve adherence, and in turn reduce the distress caused by the experiences of schizophrenia is urgently needed (Nagai et al, 2020). Addressing the impact of attitude on medication adherence in this population is overdue.…”