title: The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia.
abstract: BACKGROUND
  Evidence-based interventions to improve medication adherence among patients with schizophrenia are lacking. Although family psychoeducation has demonstrated efficacy in improving outcomes in schizophrenia, empirical support for its ability to enhance medication adherence is scarce.
  
  
  OBJECTIVE
  To determine whether a culturally adapted, multifamily group (MFG) therapy would increase medication adherence and decrease psychiatric hospitalizations for Spanish-speaking Mexican Americans with schizophrenia.
  
  
  METHODS
  A total of 174 Mexican American adults with schizophrenia-spectrum disorder and their key relatives were studied in a 3-armed, randomized controlled trial of MFG therapy focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months.
  
  
  METHODS
  Two community mental health centers in Los Angeles, California.
  
  
  METHODS
  Patients had a diagnosis of schizophrenia or schizoaffective disorder with a recent exacerbation of psychotic symptoms and nonadherence to medication before enrollment. Intervention  Patients participated in 1 of 2 MFGs (MFG-adherence or MFG-standard) or treatment as usual. Groups convened twice monthly in 90-minute sessions for 1 year.
  
  
  METHODS
  The Treatment Compliance Interview uses multiple sources of information to quantify medication adherence. Computerized records were used to collect information on the use of inpatient resources.
  
  
  RESULTS
  At the end of the 1-year treatment, MFG-adherence was associated with higher medication adherence than MFG-standard or treatment as usual only (F = 6.41; P = .003). The MFG-adherence participants had a longer time to first hospitalization (χ(2) = 13.3; P = .001) and were less likely to be hospitalized than those in MFG-standard (χ(2) = 8.2; P = .04) and treatment as usual alone (χ(2) = 11.3; P < .001). Increased adherence accounted for one-third of the overall effect of treatment on the reduced risk for psychiatric hospitalization.
  
  
  CONCLUSIONS
  Multifamily group therapy specifically tailored to improve medication adherence through a focus on the beliefs and attitudes of the target population is associated with improved outcome for Mexican American adults with schizophrenia-spectrum disorders. Trial Registration  clinicaltrials.gov Identifier: NCT01125267.
authors.affiliation: David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. akopel@ucla.edu
authors.forename: Alex
authors.initials: A
authors.lastname: Kopelowicz
authors.forename: Roberto
authors.initials: R
authors.lastname: Zarate
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Wallace
authors.forename: Robert Paul
authors.initials: RP
authors.lastname: Liberman
authors.forename: Steven R
authors.initials: SR
authors.lastname: Lopez
authors.forename: Jim
authors.initials: J
authors.lastname: Mintz
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005196:Family Therapy / Q000379:methods; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology*; D017058:Mexican Americans / Q000523:psychology*; D010352:Patient Dropouts; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods; D012559:Schizophrenia / Q000188:drug therapy* / Q000208:ethnology
chemical_list: D014150:Antipsychotic Agents