Validity of electronically monitored medication adherence and conventional adherence measures in schizophrenia.
OBJECTIVE
This study evaluated the validity of prescriber, patient, and research assistant ratings of adherence to prescribed oral antipsychotic medication among outpatients with schizophrenia or schizoaffective disorder in comparison with electronic monitoring.


METHODS
Adult outpatients with schizophrenia (N=35) or schizoaffective disorder (N=26) received adherence assessments via electronically monitored medication vial caps as well as by monthly prescriber, patient, and research assistant report for up to six months.


RESULTS
Electronic monitoring detected greater nonadherence rates (57%) than either prescribers (7%) or patients (5%), though the research assistant ratings were 54%. No directional bias was found between electronic monitoring and assignment of adherence by research assistants, although disagreement occurred in 36% of cases.


CONCLUSIONS
Both patients and prescribers grossly overestimated medication adherence, which may interfere with or reduce the effectiveness of diligent medication management.
Byerly
Matthew J
MJ
Department of Psychiatry, University of Texas Southwestern Medical Center 6363 Forest Park Rd., Suite 651, Dallas, TX 75235-8828, USA. matt.byerly@utsouthwestern.edu
Thompson
Ann
A
Carmody
Thomas
T
Bugno
Rhiannon
R
Erwin
Thomas
T
Kashner
Michael
M
Rush
A John
AJ
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015982:Bias; D003625:Data Collection / Q000706:statistics & numerical data*; D016903:Drug Monitoring; D004349:Drug Packaging; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012650:Self Disclosure
D014150:Antipsychotic Agents