Adherence to antipsychotics among Latinos and Asians with schizophrenia and limited English proficiency.
OBJECTIVE
The authors examined data for 7,784 Latino, Asian, and non-Latino white Medi-Cal beneficiaries with schizophrenia to determine the relationship between patients' preferred language for mental health services--English, Spanish, or an Asian language--and their adherence to treatment with antipsychotic medications.


METHODS
Data reflected 31,560 person-years from 1999 to 2004. Pharmacy records were analyzed to assess medication adherence by use of the medication possession ratio (MPR). Clients were defined as nonadherent (MPR<.5), partially adherent (MPR=.5-<.8), or adherent (MPR=.8-1.1) or as an excess filler of prescriptions (MPR<1.1). Regression models were used to examine adherence, hospitalization, and costs by race-ethnicity and language status.


RESULTS
Latinos with limited English proficiency were more likely than English-proficient Latinos to be medication adherent (41% versus 36%; p<.001) and less likely to be excess fillers (15% versus 20%; p<.001). Asians with limited English proficiency were less likely than English-proficient Asians to be adherent (40% versus 45%; p=.034), more likely to be nonadherent (29% versus 22%; p<.001), and less likely to be excess fillers (13% versus 17%; p=.004). When analyses controlled for adherence and comorbidities, clients with limited English proficiency had lower rates of hospitalization and lower health care costs than English-proficient and white clients.


CONCLUSIONS
Adherence to antipsychotic medications varied by English proficiency among and within ethnic groups. Policies supporting the training of bilingual and multicultural providers from ethnic minority groups and interventions that capitalize on patients' existing social support networks may improve adherence to treatment in linguistically diverse populations.
Gilmer
Todd P
TP
Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0622, USA. tgilmer@ucsd.edu
Ojeda
Victoria D
VD
Barrio
Concepcion
C
Fuentes
Dahlia
D
Garcia
Piedad
P
Lanouette
Nicole M
NM
Lee
Kelly C
KC
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001213:Asian; D002140:California; D003144:Communication Barriers; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology*; D012559:Schizophrenia / Q000188:drug therapy* / Q000208:ethnology; D014481:United States
D014150:Antipsychotic Agents