title: Medication adherence in schizophrenia: exploring patients', carers' and professionals' views.
abstract: One of the major clinical problems in the treatment of people with schizophrenia is suboptimal medication adherence. Most research focusing on determinants of nonadherence use quantitative research methods. These studies have some important limitations in exploring the decision-making process of patients concerning medication. In this study we explore factors influencing medication adherence behavior in people with schizophrenia using concept mapping. Concept mapping is a structured qualitative method and was performed in 4 European countries. Participants were 27 patients with schizophrenia, 29 carers, and 28 professionals of patients with schizophrenia. Five clinically relevant themes were identified that affect adherence: medication efficacy, external factors (such as patient support and therapeutic alliance), insight, side effects, and attitudes toward medication. Importance ratings of these factors differed significantly between professionals and carers and patients. Professionals, carers, and patients do not have a shared understanding of which factors are important in patients' medication adherence behavior. Adherence may be positively influenced if professionals focus on the positive aspects of medication, on enhancing insight, and on fostering a positive therapeutic relationship with patients and carers.
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands. m.j.kikkert@amc.uva.nl
authors.forename: Martijn J
authors.initials: MJ
authors.lastname: Kikkert
authors.forename: Aart H
authors.initials: AH
authors.lastname: Schene
authors.forename: Maarten W J
authors.initials: MW
authors.lastname: Koeter
authors.forename: Debbie
authors.initials: D
authors.lastname: Robson
authors.forename: Anja
authors.initials: A
authors.lastname: Born
authors.forename: Hedda
authors.initials: H
authors.lastname: Helm
authors.forename: Michela
authors.initials: M
authors.lastname: Nose
authors.forename: Claudia
authors.initials: C
authors.lastname: Goss
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001290:Attitude; D001291:Attitude of Health Personnel; D001364:Awareness; D017028:Caregivers / Q000523:psychology*; D003210:Concept Formation; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011613:Psychotherapy; D011788:Quality of Life / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology*
chemical_list: D014150:Antipsychotic Agents