Treatment adherence therapy in people with psychotic disorders: randomised controlled trial.
BACKGROUND
Interventions to improve adherence to treatment in people with psychotic disorders have produced inconclusive results. We developed a new treatment, treatment adherence therapy (TAT), whose intervention modules are tailored to the reasons for an individual's non-adherence.


OBJECTIVE
To examine the effectiveness of TAT with regard to service engagement and medication adherence in out-patients with psychotic disorders who engage poorly.


METHODS
Randomised controlled study of TAT v. treatment as usual (TAU) in 109 out-patients. Most outcome measurements were performed by masked assessors. We used intention-to-treat multivariate analyses (Dutch Trial Registry: NTR1159).


RESULTS
Treatment adherence therapy v. TAU significantly benefited service engagement (Cohen's d = 0.48) and medication adherence (Cohen's d = 0.43). Results remained significant at 6-month follow-up for medication adherence. Near-significant effects were also found regarding involuntary readmissions (1.9% v. 11.8%, P = 0.053). Symptoms and quality of life did not improve.


CONCLUSIONS
Treatment adherence therapy helps improve engagement and adherence, and may prevent involuntary admission.
Erasmus University Medical Center, Department of Psychiatry, Rotterdam, The Netherlands. tonnie@backwash.org
A B P
AB
Staring
M
M
Van der Gaag
G T
GT
Koopmans
J P
JP
Selten
J M
JM
Van Beveren
M W
MW
Hengeveld
A J M
AJ
Loonen
C L
CL
Mulder
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D057194:Intention to Treat Analysis; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D009042:Motivation; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D055502:Secondary Prevention; D016896:Treatment Outcome
D014150:Antipsychotic Agents