title: A review of behavioral tailoring strategies for improving medication adherence in serious mental illness.
abstract: Nonadherence to psychopharmacological treatments poses a significant challenge to treatment success in individuals with serious mental illness, with upwards of 60% of people not taking their psychiatric medications as prescribed. Nonadherence is associated with adverse outcomes, including exacerbation of psychiatric symptoms, impaired functioning, increased hospitalizations and emergency room use, and increased health care costs. Whereas interventions using psychoeducation or cognitive approaches, such as motivational interviewing, have largely proven ineffective in improving adherence, approaches employing behavioral tailoring that incorporate medication taking into the daily routine and/or use environmental supports have shown promise. Recently, adherence-enhancing behavioral tailoring interventions that utilize novel technologies, such as electronic monitors and mobile phones, have been developed. Although interventions utilizing these platforms have the potential for widespread dissemination to a broad range of individuals, most require further empirical testing. This paper reviews selected behavioral tailoring strategies that aim to improve medication adherence and other functional outcomes among individuals with serious mental illness.
authors.affiliation: University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, Maryland, USA ; VA Capitol Healthcare Network (VISN 5) Mental lllness Research, Education, and Clinical Center (MIRECC), Baltimore, Maryland, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Kreyenbuhl
authors.affiliation: University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Record
authors.affiliation: University of Maryland School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, Maryland, USA; University of Maryland School of edicine, Baltimore, Maryland, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Palmer-Bacon
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015438:Health Behavior; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D000068997:Smartphone / Q000639:trends; D060145:Text Messaging / Q000639:trends; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs
keywords: behavioral tailoring; intervention; medication adherence; serious mental illness; technology