Partial compliance with antipsychotics and its impact on patient outcomes

Abstract

Partial compliance with antipsychotic medications is a common and complex phenomenon that is underestimated by physicians. The consequences of partial compliance include an increased risk of relapse, rehospitalization and suicide attempts. Stigma, negative attitudes towards medications, cognitive impairment and diminished insight negatively impact treatment adherence. Oral atypical antipsychotics may improve both insight and cognitive function, but compliance with these agents is not assured. Depot conventional antipsychotics ensure medication delivery but are associated with side-effects such as EPS and dysphoria that decrease compliance. Long-acting atypicals provide significant symptom improvement, foster adherence and may help achieve improvement in insight and cognition. Addressing issues of partial and non-compliance is a significant consideration in relapse prevention strategies for patients with schizophrenia, given the devastating consequences associated with psychotic relapses.

Influencing factors of community mental health nurses caring for people with schizophrenia in Taiwan

“…Regular medication helps to stabilize the illness, and research has shown that better drug compliance results in a lower re‐hospitalization rate and improves both insight and cognitive function (Narasimhan et al . 2007, Llorca 2008).…”

Motivational Interviewing: Addressing Ambivalence to Improve Medication Adherence in Patients with Bipolar Disorder

“…In fact, medication non-adherence is a major factor for the recurrence of psychiatric symptoms, relapse, and re-hospitalization (McCann, Boardman, & Clark, 2008). Even partial adherence to psychotropic medication can result in negative outcomes, including symptom exacerbation, suicidal ideation, and suicide attempts (Narasimhan, Pae, Masand, & Masand, 2007). Considering the clinical consequences of poor medication adherence in psychiatric patients, research has shown that the principles of Motivational Interviewing (MI) can be used in clinical practice to improve patients' attitudes and insight as well as their adherence to treatment (Tay, 2007;Rusch & Corrigan, 2002).…”

Adherence According to Mary Poppins: Strategies to Make the Medicine Go Down

“…Efficacy. The CATIE project found that 24% of discontinuation was caused by lack of efficacy (Narasimhan, Pae, Masand, & Masand, 2007).…”