title: The effect of providing patient-specific electronically monitored antipsychotic medication adherence results on the treatment planning of prescribers of outpatients with schizophrenia.
abstract: Adherence to antipsychotic medication was assessed monthly over a 6-month study period using patient-specific electronic monitoring (EM) of medication bottle opening in 23 outpatients with schizophrenia or schizoaffective disorder. Patient-specific EM adherence results were then shared with the seven participating prescribers, who were surveyed concerning the treatment changes, if any, that they would recommend based on the EM adherence results. Prescribers indicated that they would recommend adherence-related treatment plan changes in 61% of patients, all of whom were ≤80% adherent. The strength of this effect was significantly stronger for psychosocial intervention treatment plan change recommendations than for medication treatment plan change recommendations. Of the psychosocial intervention recommendations, an increase in case management intensity was most often recommended. Of the medication treatment plan recommendations, initiation of a long-acting injectable medication and an increase in dosage of current oral antipsychotic medication were each recommended in only one case. Prescriber recommendations of adherence interventions in this study were not necessarily consistent with major guideline recommendations. Findings suggest the need for further study and dissemination of findings regarding evidence-based adherence assessment and interventions.
authors.affiliation: Department of Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. paul.nakonezny@utsouthwestern.edu
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nakonezny
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Byerly
authors.forename: Amit
authors.initials: A
authors.lastname: Pradhan
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology; D012559:Schizophrenia / Q000188:drug therapy* / Q000628:therapy*; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents