title: Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis.
abstract: BACKGROUND
  Poor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control. Adherence therapy (AT) is an intervention that seeks to reduce patients' psychiatric symptoms by enhancing treatment adherence. We aimed to systematically review the trial evidence of the effectiveness of AT on improving clinical outcomes in these patients.
  
  
  METHODS
  Systematic review and meta-analysis of published RCTs. We included studies testing AT as an adjunct intervention against treatment as usual or a comparator intervention in the general adult psychiatric population. The primary outcome of interest was improvement in psychiatric symptoms.
  
  
  RESULTS
  We included six studies testing AT in schizophrenia spectrum disorders published since 2006. A meta-analysis showed AT significantly reduced psychiatric symptoms compared to usual treatment over a follow-up period of less than 1 year. We found no significant effects of AT on patients' adherence and adherence attitudes.
  
  
  CONCLUSIONS
  AT is an effective adjunctive treatment for people with schizophrenia spectrum disorders.
  CRD42015016779.
authors.affiliation: Health Services and Population Research Centre, Hamad Medical Corporation, Doha, Qatar. rgray@hamad.qa.|The University of South Australia, Adelaide, Australia. rgray@hamad.qa.
authors.forename: Richard
authors.initials: R
authors.lastname: Gray
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bressington
authors.affiliation: Independent Research Consultant, ADIGO, Bratislava, Slovakia.
authors.forename: Ada
authors.initials: A
authors.lastname: Ivanecka
authors.affiliation: Northamptonshire Healthcare NHS Foundation Trust, Northamptonshire, UK.|University College London, London, UK.|University of Northampton, Northampton, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Hardy
authors.affiliation: University of South Australia Department of Rural Health (DRH), University of South Australia, Whyalla Norrie, Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Jones
authors.affiliation: Diaconic University of Applied Sciences Bielefeld, Bielefeld, Germany.|Institute of Nursing and Healthcare at the Medical Faculty of Halle-Wittenberg University, Halle-Wittenberg, Sachsen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schulz
authors.affiliation: Research and International Affairs Boromarajonani College of Nursing Changwat Nonthaburi, Nonthaburi, Thailand.
authors.forename: Suparpit
authors.initials: S
authors.lastname: von Bormann
authors.affiliation: Learning Teaching and Quality, Faculty of Health and Social Care, University of Hull, Hull, UK.
authors.forename: Jacquie
authors.initials: J
authors.lastname: White
authors.affiliation: Center for Nursing Scholarship & Research, Georgia Southern University Nursing, Statesboro, Georgia, USA.
authors.forename: Kathryn Hoehn
authors.initials: KH
authors.lastname: Anderson
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
authors.forename: Wai-Tong
authors.initials: WT
authors.lastname: Chien
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy* / Q000628:therapy; D016896:Treatment Outcome
keywords: Adherence; Adherence therapy; Compliance; Meta-analysis; Schizophrenia; Schizophrenia-spectrum disorders; Systematic review