title: Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode.
abstract: BACKGROUND
  Many patients recovering from a first psychotic episode will discontinue medication against medical advice, even before a 1-year treatment course is completed. Factors associated with treatment adherence in patients with chronic schizophrenia include beliefs about severity of illness and need for treatment, treatment with typical versus atypical antipsychotic and medication side effects.
  
  
  METHODS
  In this 2-year prospective study of 254 patients recovering from a first episode of schizophrenia, schizophreniform, or schizoaffective disorder we examined the relationship between antipsychotic medication non-adherence and patient beliefs about: need for treatment, antipsychotic medication benefits, and negative aspects of antipsychotic medication treatment. We also examined the relationship between medication non-adherence and treatment with either haloperidol or olanzapine, and objective measures of symptom response and side effects.
  
  
  RESULTS
  The likelihood of becoming medication non-adherent for 1 week or longer was greater in subjects whose belief in need for treatment was less (HR=1.75, 95% CI 1.16, 2.65, p=0.0077) or who believed medications were of low benefit (HR=2.88, 95 CI 1.79-4.65, p<0.0001). Subjects randomized to haloperidol were more likely to become medication non-adherent for >or=1 week than subjects randomized to olanzapine (HR-1.51, 95% CI 1.01, 2.27, p=0.045).
  
  
  CONCLUSIONS
  Beliefs about need for treatment and the benefits of antipsychotic medication may be intervention targets to improve likelihood of long-term medication adherence in patients recovering from a first episode of schizophrenia, schizoaffective, or schizophreniform disorder.
authors.affiliation: Department of Psychiatry, C.B.# 7160, University of North Carolina School of Medicine, Chapel Hill, 27599-7160, USA.
authors.forename: Diana O
authors.initials: DO
authors.lastname: Perkins
authors.forename: Jacqueline L
authors.initials: JL
authors.lastname: Johnson
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hamer
authors.forename: Robert B
authors.initials: RB
authors.lastname: Zipursky
authors.forename: Richard S
authors.initials: RS
authors.lastname: Keefe
authors.forename: Franca
authors.initials: F
authors.lastname: Centorrhino
authors.forename: Alan I
authors.initials: AI
authors.lastname: Green
authors.forename: Ira B
authors.initials: IB
authors.lastname: Glick
authors.forename: Rene S
authors.initials: RS
authors.lastname: Kahn
authors.forename: Tonmoy
authors.initials: T
authors.lastname: Sharma
authors.forename: Mauricio
authors.initials: M
authors.lastname: Tohen
authors.forename: Joseph P
authors.initials: JP
authors.lastname: McEvoy
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Weiden
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lieberman
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001294:Attitude to Health; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008960:Models, Psychological; D000077152:Olanzapine; D010349:Patient Compliance / Q000523:psychology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D006220:Haloperidol; D000077152:Olanzapine