Evaluation of the factors interfering with drug treatment compliance among Brazilian patients with schizophrenia.
BACKGROUND
Treatment noncompliance among schizophrenic patients is as high as 50%. In order to rate compliance and assess the most significant differences between compliant and noncompliant patients, a Brazilian population of schizophrenic outpatients was followed for one year.


METHODS
Fifty outpatients were selected. Clinical interview, the Brief Psychiatric Rating Scale--Anchored version (BPRS-A) and an expanded version of the Rating of Medical Influences (ROMI) scale (used to rate patient attitudes toward compliance) were applied at baseline. The BPRS-A was used in the follow-up visits (approximately once a month). Missing two consecutive appointments without explanation or taking less than 75% of the medication (by written family report) was considered noncompliance.


RESULTS
Noncompliance was 48% over one year. Patients in the noncompliant group presented initial worsening of psychotic symptoms (p < 0.05) and had been treated for a shorter length of time (p = 0.007). The ROMI scale showed that "perceived day-to-day benefit" was most strongly correlated with compliance, and feeling "distressed by side effects" was most strongly correlated with noncompliance.


CONCLUSIONS
This study evaluates the frequency of noncompliance and the main reasons for complying in a population of schizophrenic outpatients.


CONCLUSIONS
Severity of psychopathology was found to correlate with noncompliance (although not necessarily as its cause), as well as with duration of treatment. Noncompliance rates are high and must be taken into account in any treatment program.
Rosa
Moacyr Alexandro
MA
Psychiatry Unit, Universidade de São Paulo, São Paulo, SP, Brazil. moarosa@yahoo.com
Marcolin
Marco Antônio
MA
Elkis
Hélio
H
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001938:Brazil; D010054:Brief Psychiatric Rating Scale / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data*
D014150:Antipsychotic Agents