title: Effect of a Multi-Dimensional and Inter-Sectoral Intervention on the Adherence of Psychiatric Patients.
abstract: BACKGROUND
  In psychiatry, hospital stays and transitions to the ambulatory sector are susceptible to major changes in drug therapy that lead to complex medication regimens and common non-adherence among psychiatric patients. A multi-dimensional and inter-sectoral intervention is hypothesized to improve the adherence of psychiatric patients to their pharmacotherapy.
  
  
  METHODS
  269 patients from a German university hospital were included in a prospective, open, clinical trial with consecutive control and intervention groups. Control patients (09/2012-03/2013) received usual care, whereas intervention patients (05/2013-12/2013) underwent a program to enhance adherence during their stay and up to three months after discharge. The program consisted of therapy simplification and individualized patient education (multi-dimensional component) during the stay and at discharge, as well as subsequent phone calls after discharge (inter-sectoral component). Adherence was measured by the "Medication Adherence Report Scale" (MARS) and the "Drug Attitude Inventory" (DAI).
  
  
  RESULTS
  The improvement in the MARS score between admission and three months after discharge was 1.33 points (95% CI: 0.73-1.93) higher in the intervention group compared to controls. In addition, the DAI score improved 1.93 points (95% CI: 1.15-2.72) more for intervention patients.
  
  
  CONCLUSIONS
  These two findings indicate significantly higher medication adherence following the investigated multi-dimensional and inter-sectoral program.
  
  
  BACKGROUND
  German Clinical Trials Register DRKS00006358.
authors.affiliation: Molecular & Clinical Pharmacy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Pauly
authors.affiliation: Molecular & Clinical Pharmacy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Wolf
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mayr
authors.affiliation: Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Lenz
authors.affiliation: Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kornhuber
authors.affiliation: Molecular & Clinical Pharmacy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Friedland
mesh_terms: D000328:Adult; D000359:Aftercare / Q000458:organization & administration; D001294:Attitude to Health; D004334:Drug Administration Schedule; D004349:Drug Packaging; D005260:Female; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D055118:Medication Adherence; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic; D010595:Pharmacists; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012646:Self Administration / Q000379:methods / Q000523:psychology; D057566:Self Report; D011795:Surveys and Questionnaires
chemical_list: D011619:Psychotropic Drugs