title: Effects of integrated treatment on antipsychotic medication adherence in a randomized trial in recent-onset schizophrenia.
abstract: OBJECTIVE
  Interventions improving adherence to antipsychotic medication are needed. The present study examined the effects on medication adherence of 2 years of integrated treatment for patients with schizophrenia.
  
  
  METHODS
  Adherence to medication was examined in a randomized controlled trial of 2 years of integrated treatment versus standard treatment. The 50 included patients were consecutively referred to a specialized psychiatric team for treatment of psychosis and were diagnosed with DSM-IV schizophrenia or schizoaffective or schizophreniform disorder. The patients were clinically stable and had less than 2 years' duration of illness. Integrated treatment consisted of assertive outreach community treatment, family psychoeducation and involvement, and social skills training. Good adherence was defined as less than 1 month without medication. Outcomes were compared over 12-month and 24-month follow-up periods. The study was conducted from February 1992 to October 1999.
  
  
  RESULTS
  No difference in adherence between the integrated treatment group and the standard treatment group (chi(2) = 0.06, NS) was found. Men were more nonadherent than women (OR 6.11 [CI 1.25 to 29.74], p = .025). Patients living in families with low expressed emotion were less adherent than patients living in families with high expressed emotion (OR 6.04 [CI 1.07 to 34.13], p = .042).
  
  
  CONCLUSIONS
  No effects of integrated treatment on medication adherence were found.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier NCT00184509.
authors.affiliation: Division of Psychiatry, Department of Østmarka, St. Olav's University Hospital, Trondheim, Norway. gunnar.morken@ntnu.no
authors.forename: Gunnar
authors.initials: G
authors.lastname: Morken
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Grawe
authors.forename: Jan H
authors.initials: JH
authors.lastname: Widen
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019090:Case Management; D019260:Expressed Emotion; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010348:Patient Care Team; D010349:Patient Compliance; D012559:Schizophrenia / Q000188:drug therapy* / Q000534:rehabilitation; D012744:Sex Ratio
chemical_list: D014150:Antipsychotic Agents