title: Nurses' perceptions of medication adherence in schizophrenia: results of the ADHES cross-sectional questionnaire survey.
abstract: OBJECTIVE
  Poor adherence to antipsychotic treatment is a widespread problem within schizophrenia therapy with serious consequences including increased risks of relapse and rehospitalization. Mounting evidence supports the key roles that nurses play in monitoring patient progress and facilitating long-term treatment adherence. The Adherencia Terapéutica en la Esquizofrenia (ADHES) nurses' survey was designed to assess the opinions of nurses on the causes and management of partial/nonadherence to antipsychotic medication.
  
  
  METHODS
  A questionnaire-based cross-sectional survey of 4120 nurses from Europe, the Middle East and Africa. Interpretation of results was based on a descriptive comparison of responses.
  
  
  RESULTS
  Nurses perceived 54% of patients seen in the preceding month to be partially/nonadherent to treatment. Most nurses (90%) reported some level of experience with administration of long-acting injectable (LAI) antipsychotics, with 24% of nurses administering >10 injections per month. The majority (85%) of nurses surveyed believed that improving adherence would improve patient outcomes. Nearly half (49%) reported that most of their patients depend on a family member or other nonprofessional carer to remind them to take their medication as prescribed. A similar proportion of nurses (43%) reported that most of their patients relied on a professional to remind them to take medication. Most nurses (92%) felt that ensuring continuous medication with LAI antipsychotics would yield long-term benefits for patients, but their opinion was that over a third of patients were unaware of LAI antipsychotic treatments. In a series of forced options, the strategy used most often by respondents (89%) to promote medication adherence was to build trusting relationships with patients while listening to and interpreting their needs and concerns. Respondents also rated this as the most effective strategy that they used (48%).
  
  
  CONCLUSIONS
  Nurses are highly aware of adherence issues faced by their patients; further patient education on treatment options is needed.
authors.affiliation: Department of Psychiatry, University of Stellenbosch, Tygerberg 7505, Cape Town, South Africa.
authors.forename: Robin
authors.initials: R
authors.lastname: Emsley
authors.affiliation: Department of Psychiatry, Dokuz Eylül University School of Medicine, Izmir, Turkey.
authors.forename: Koksal
authors.initials: K
authors.lastname: Alptekin
authors.affiliation: SHU Psychiatrie Adultes, Sainte Marguerite Hospital, Marseilles, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Azorin
authors.affiliation: Department of Psychiatry, Hospital Dr R Lafora, Cra de Colmenar Viejo, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Cañas
authors.affiliation: Service de psychiatrie adulte, Cliniques universitaires St-Luc, Bruxelles, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dubois
authors.affiliation: CMME, Hôpital Sainte-Anne (Paris Descartes), Paris, France.
authors.forename: Philip
authors.initials: P
authors.lastname: Gorwood
authors.affiliation: Greater Manchester West Mental Health NHS Foundation Trust and Department of Psychiatry, University of Manchester, Manchester, UK.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Haddad
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Naber
authors.affiliation: Department of Psychiatry, Hospital Meixoeiro, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Olivares
authors.affiliation: Department of Psychiatry, Evangelismos General Hospital, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Papageorgiou
authors.affiliation: Unidad de Psiquiatría, Hospital Juan March, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears, Palma de Mallorca, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Roca
authors.affiliation: Service de Psychiatrie, Hôpital M. Fontan, Lille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Department of Medical and Scientific Affairs, Janssen EMEA, Neuss, Germany.
authors.forename: Ludger
authors.initials: L
authors.lastname: Hargarter
authors.affiliation: Department of Medical and Scientific Affairs, Janssen EMEA, Neuss, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schreiner
keywords: adherence; antipsychotic; nurse; schizophrenia; survey
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