title: A systematic review of service-user reasons for adherence and nonadherence to neuroleptic medication in psychosis.
abstract: People diagnosed with psychosis, such as those with schizophrenia-related disorders, are routinely prescribed neuroleptic medication as a primary treatment. Despite reported benefits of neuroleptic treatment for symptom remission and relapse prevention, discontinuation rates are high. Research examining factors associated with neuroleptic non-adherence report inconsistent findings. Reasons for adherence to neuroleptic medication are under-researched. The current review aimed to synthesise evidence exploring service-user self-reported reasons for adherence and non-adherence to neuroleptic medication. A systematic literature search of databases and reference list searching identified 21 studies investigating service-user accounts of reasons for adherence and/or non-adherence to neuroleptic medication. Qualitative, quantitative and mixed-method studies were included in the review. Several themes of reasons were identified. Reasons for both adherence and non-adherence were largely similar; medication efficacy, compatibility with personal medication or religious beliefs, side-effects and the influence of relationships with other people. Experiences of stigma and economic difficulties were generally identified as reasons for non-adherence only while experiences of fear and coercion were identified as reasons for adherence only. The review identified crucial factors which may aid service providers in bettering treatment for people with psychosis and will provide evidence which could contribute to future prescribing guidelines.
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, 2nd Floor Zochonis Building, Brunswick Street, University of Manchester, M13 9PL United Kingdom. Electronic address: miriam.wade@postgrad.manchester.ac.uk.
authors.forename: Miriam
authors.initials: M
authors.lastname: Wade
authors.affiliation: University of Manchester, Manchester, United Kingdom. Electronic address: sara.tai@manchester.ac.uk.
authors.forename: Sara
authors.initials: S
authors.lastname: Tai
authors.affiliation: University of Manchester, Manchester, United Kingdom.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Awenat
authors.affiliation: University of Manchester, Manchester, United Kingdom.
authors.forename: Gillian
authors.initials: G
authors.lastname: Haddock
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D011618:Psychotic Disorders / Q000188:drug therapy*; D012559:Schizophrenia / Q000188:drug therapy*; D057545:Social Stigma
chemical_list: D014150:Antipsychotic Agents
keywords: Adherence; Antipsychotic medication; Neuroleptic medication; Non-adherence; Psychosis; Schizophrenia