title: Determination of Adherence Profiles in Schizophrenia Using Self-Reported Adherence: Results From the FACE-SZ Dataset.
abstract: Medication nonadherence is one of the most important, and potentially modifiable, prognostic factors in the outcome of patients with schizophrenia. The aim of this article is to propose a new classification of adherence profiles according to the Medication Adherence Rating Scale (MARS) in a large community-dwelling sample of French patients with schizophrenia to provide a new tool to help clinicians in daily practice.
  
  
  
  319 community-dwelling patients from a national network of 10 Schizophrenia Expert Centers were interviewed between January 2009 and January 2014. Assessments were conducted with a dedicated electronic medical record including the Structured Clinical Interview for DSM-IV Disorders. A cluster analysis was performed to explore clinical variables associated with poor adherence.
  
  
  
  Two distinct groups of patients were identified relative to their main adherence style. Items about medications' subjective negative effects constituted the greatest discriminating factor between the 2 clusters. Patients with poor adherence (n = 117) were significantly younger (adjusted OR [aOR] = 1.036; 95% CI, 1.004-1.069) and had higher levels of current depression (aOR = 0.894; 95% CI, 0.829-0.964) and lower insight (aOR = 0.820; 95% CI, 0.693-0.970).
  
  
  
  The MARS provides a useful tool for clinicians and can also aid in the evaluation of adherence styles and their determinants in patients with schizophrenia. The element providing the greatest discriminative power between the 2 clusters was a subjective negative attitude toward medication. The findings also suggest that depression is more frequent in schizophrenia patients with poor adherence and that improving insight into illness might be suggested as a first-line intervention to improve adherence in this population.
authors: Centre Hospitalier Charles Perrens, CNRS UMR 5287-INCIA, 121 Rue de la Béchade, 33076 Bordeaux, France. david.misdrahi@u-bordeaux.fr.|Fondation FondaMental, Créteil, France.|Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux; CNRS UMR 5287-INCIA, Bordeaux, France.
authors: David
authors: D
authors: Misdrahi
authors: Fondation FondaMental, Créteil, France.|Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux; CNRS UMR 5287-INCIA, Bordeaux, France.
authors: Arnaud
authors: A
authors: Tessier
authors: Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux; CNRS UMR 5287-INCIA, Bordeaux, France.
authors: Joel
authors: J
authors: Swendsen
authors: Fondation FondaMental, Créteil, France.|Strasbourg University Hospital, University of Strasbourg, INSERM U1114, Federation of Translational Psychiatry, Strasbourg, France.
authors: Fabrice
authors: F
authors: Berna
authors: Fondation FondaMental, Créteil, France.|University Department of Psychiatry, H. Mondor Hospital, INSERM U955, Translational Psychiatry Team, Creteil, France, Paris Est University, DHU Pe-PSY, Creteil, France.
authors: Lore
authors: L
authors: Brunel
authors: Fondation FondaMental, Créteil, France.|University Department of Adult Psychiatry, La Colombiere Hospital, University of Montpellier 1, Inserm 1061, Montpellier, France.
authors: Delphine
authors: D
authors: Capdevielle
authors: Fondation FondaMental, Créteil, France.|Clermont-Ferrand University Hospital, EA 7280, Clermont-Ferrand University, Clermont-Ferrand, France.
authors: Isabelle
authors: I
authors: Chereau
authors: Fondation FondaMental, Créteil, France.|Strasbourg University Hospital, University of Strasbourg, INSERM U1114, Federation of Translational Psychiatry, Strasbourg, France.
authors: Jean-Marie
authors: JM
authors: Danion
authors: Fondation FondaMental, Créteil, France.|Department of Psychiatry, AP-HP Louis Mourier Hospital, Colombes, Inserm U894, University of Paris Diderot, Sorbonne Paris Cité, France.
authors: Marie
authors: M
authors: De Pradier
authors: Fondation FondaMental, Créteil, France.|University of Claude Bernard Lyon 1, Le Vinatier Hospital Pole Est, BRON Cedex, France.
authors: Jean-Michel
authors: JM
authors: Dorey
authors: Fondation FondaMental, Créteil, France.|Department of Psychiatry, AP-HP Louis Mourier Hospital, Colombes, Inserm U894, University of Paris Diderot, Sorbonne Paris Cité, France.
authors: Caroline
authors: C
authors: Dubertret
authors: Fondation FondaMental, Créteil, France.|Center of Reference for Psychosocial Rehabilitation, Alpes Isère Hospital, Grenoble, France.
authors: Julien
authors: J
authors: Dubreucq
authors: Fondation FondaMental, Créteil, France.|Department of Psychiatry, Sainte-Marguerite University Hospital, AP-HM, Marseille, France.
authors: Catherine
authors: C
authors: Faget
authors: Fondation FondaMental, Créteil, France.|Center of Reference for Psychosocial Rehabilitation, Alpes Isère Hospital, Grenoble, France.
authors: Franck
authors: F
authors: Gabayet
authors: Fondation FondaMental, Créteil, France.|University of Claude Bernard Lyon 1, Le Vinatier Hospital Pole Est, BRON Cedex, France.
authors: Romain
authors: R
authors: Rey
authors: Fondation FondaMental, Créteil, France.|Department of Psychiatry, Sainte-Marguerite University Hospital, AP-HM, Marseille, France.
authors: Raphaelle
authors: R
authors: Richieri
authors: Fondation FondaMental, Créteil, France.|Department of Adult Psychiatry, Versailles Hospital, UFR of Health Sciences Simone Veil, University of Versailles, Versailles, France.
authors: Christine
authors: C
authors: Passerieux
authors: Fondation FondaMental, Créteil, France.|University Department of Adult Psychiatry, La Colombiere Hospital, University of Montpellier 1, Inserm 1061, Montpellier, France.
authors: Aurélie
authors: A
authors: Schandrin
authors: Fondation FondaMental, Créteil, France.|University Department of Psychiatry, H. Mondor Hospital, INSERM U955, Translational Psychiatry Team, Creteil, France, Paris Est University, DHU Pe-PSY, Creteil, France.
authors: Franck
authors: F
authors: Schurhoff
authors: Fondation FondaMental, Créteil, France.|Clermont-Ferrand University Hospital, EA 7280, Clermont-Ferrand University, Clermont-Ferrand, France.
authors: Anne Marie
authors: AM
authors: Tronche
authors: Fondation FondaMental, Créteil, France.|Department of Adult Psychiatry, Versailles Hospital, UFR of Health Sciences Simone Veil, University of Versailles, Versailles, France.
authors: Mathieu
authors: M
authors: Urbach
authors: Fondation FondaMental, Créteil, France.|Clermont-Ferrand University Hospital, EA 7280, Clermont-Ferrand University, Clermont-Ferrand, France.
authors: Pierre Michel
authors: PM
authors: Llorca
authors: Fondation FondaMental, Créteil, France.|University Department of Psychiatry, H. Mondor Hospital, INSERM U955, Translational Psychiatry Team, Creteil, France, Paris Est University, DHU Pe-PSY, Creteil, France.
authors: Guillaume
authors: G
authors: Fond
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D057566:Self Report; D011795:Surveys and Questionnaires / Q000592:standards*; D016903:Drug Monitoring