title: Adherence styles of schizophrenia patients identified by a latent class analysis of the Medication Adherence Rating Scale (MARS): a six-month follow-up study.
abstract: The purpose of this study was to examine patients' response profiles to the Medication Adherence Rating Scale (MARS) and to evaluate the potential of response styles as predictors of the future course of psychotic disorders in terms of rehospitalisation and maintenance of medication. A total of 371 psychiatric in-patients with schizophrenia or schizoaffective disorder who were taking part in a naturalistic long-term study completed a German version of the MARS. A Latent Class Analysis (LCA) was performed. Five latent classes of response styles could be identified: "moderately adherent", "critical discontinuers", "good compliers", "careless and forgetful", and "compliant sceptics". Class membership was found to be related to the severity of symptoms, level of functioning, insight into illness, insight into necessity of treatment, treatment satisfaction and medication side effects. At a six-month follow-up appointment, significant differences between the classes persisted. Participants showing a "good compliers" response pattern had a significantly better prognosis in terms of rehospitalisation rate and maintenance of the original medication than "critical discontinuers". Evaluation of the MARS by studying response profiles provides informative results that reach beyond the results obtained by an evaluation by scores. Patients can be classified into adherence groups that are of predictive value for long-term patient outcome.
authors.affiliation: Ulm University, Department of Psychiatry and Psychotherapy I, Zentrum für Psychiatrie Südwürttemberg, Versorgungsforschung Weissenau, Weingartshofer Str. 2, D-88214 Ravensburg, Germany. susanne.jaeger@zfp-zentrum.de
authors.forename: Susanne
authors.initials: S
authors.lastname: Jaeger
authors.forename: Carmen
authors.initials: C
authors.lastname: Pfiffner
authors.forename: Prisca
authors.initials: P
authors.lastname: Weiser
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kilian
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
authors.forename: Gerhard
authors.initials: G
authors.lastname: Längle
authors.forename: Gerhard Wilhelm
authors.initials: GW
authors.lastname: Eschweiler
authors.forename: Daniela
authors.initials: D
authors.lastname: Croissant
authors.forename: Wiltrud
authors.initials: W
authors.lastname: Schepp
authors.forename: Tilman
authors.initials: T
authors.lastname: Steinert
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D017060:Patient Satisfaction; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents