Anti-psychotics adherence among out-patients with schizophrenia in Hong Kong.
OBJECTIVE
Adherence to antipsychotic treatment is an important aspect of long term management of schizophrenia and other related psychotic disorders. The evaluation of adherence is often difficult in clinical settings. This study compared patients self-reports and clinician judgment of adherence behavior and explored their relationship with attitudes toward taking medication.


METHODS
Clinician rated questionnaire and matching patient self rated questionnaires were administered to 508 consecutive outpatients and their clinicians in four hospital clinic sites in Hong Kong. Items in the questionnaires address adherence behaviors as well as attitudes toward medication. In addition, clinicians also estimate the presence of factors unfavorable to adherence such as substance abuse, cognitive impairments etc.


RESULTS
Non-adherence was reported in at least 26% of patients. Clinician's detection of non-adherence behaviors achieved relative high specificity (0.84) but has low sensitivity (0.33). A logistic regression analysis on patients' decision to stop medication revealed that significant predictors include patients' reported lack of perception from the benefits of medication, patients' reported negative feelings associated with regular medication and younger age.


CONCLUSIONS
Non-adherence is a widespread phenomenon affecting a significant proportion of outpatients under treatment. Clinicians have relatively low sensitivity in detecting which patients are non-adherent. Non-adherence behavior is predicted by level of awareness of illness, perceived benefits of medication, negative feelings toward medication and age.
Hui
Christy Lm
CL
Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Chen
Eric Yh
EY
Kan
Cs
C
Yip
Kc
K
Law
Cw
C
Chiu
Cindy Py
CP
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents