title: Agreement between patients with schizophrenia and providers on factors of antipsychotic medication adherence.
abstract: OBJECTIVE
  Medication adherence continues to be a challenge for patients with schizophrenia. Many interventions have been tested but not widely adopted. To fill this gap, this qualitative study examined patient and provider perspectives on barriers, facilitators, and motivators related to adherence.
  
  
  METHODS
  Twenty-six patients (15 veterans and 11 nonveterans) diagnosed as having schizophrenia or schizoaffective disorder completed in-depth qualitative interviews. Each patient's mental health provider completed an open-ended paper-and-pencil questionnaire that followed the format of the patient qualitative interview. Patients and their providers were asked about seven domains of an explanatory model for schizophrenia and about barriers to, facilitators for, and motivators to taking antipsychotic medication. Patients and providers responded from the perspective of the patient. Patient interviews were audiotaped and transcribed. The data were analyzed with content analysis and constant comparison methods.
  
  
  RESULTS
  Explanatory model agreement between patients and their providers ranged from 40 to 100 percent, depending on the explanatory model domain. Patients identified 214 unique barriers, facilitators, and motivators, and agreement between patients and their providers ranged from 54 to 65 percent. Sample patient quotes are provided.
  
  
  CONCLUSIONS
  Substantial disagreement arose between patients and their providers with regard to their explanatory models for schizophrenia and the barriers, facilitators, and motivators thought to affect patients' medication adherence decisions. These findings will be used to develop and test a patient-centered strategy to enhance medication adherence.
authors.affiliation: Department of Psychiatry, Central Arkansas Veterans Healthcare System, North Little Rock, 72114, USA. jmpyne@uams.edu
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Pyne
authors.forename: Jean
authors.initials: J
authors.lastname: McSweeney
authors.forename: H Scott
authors.initials: HS
authors.lastname: Kane
authors.forename: Susan
authors.initials: S
authors.lastname: Harvey
authors.forename: Leslie
authors.initials: L
authors.lastname: Bragg
authors.forename: Ellen
authors.initials: E
authors.lastname: Fischer
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012559:Schizophrenia / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D014150:Antipsychotic Agents