A RCT of the Effects of Medication Adherence Therapy for People with Schizophrenia Specturm Disorders
Chien, Wai Tong
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Session presented on Saturday, July 26, 2014: Purpose: This randomized controlled trial, using a repeated measures control group design, tested the effectiveness of a 6-session medication adherence program for Chinese outpatients with schizophrenia and its subtypes over a 12-month follow-up. Methods: A two-site controlled trial was conducted with 134 Chinese patients with psychotic disorders in Hong Kong. The program is a motivational and insight-inducing educational program that addresses patients' awareness and knowledge of schizophrenia and skills of medication management (Gray et al., 2006) . They were randomly assigned to either the medication adherence program or usual psychiatric outpatient care. The patients' levels of medication adherence (using Drug Attitude Inventory, DAI), mental (Positive and Negative Syndrome Scale, PANSS) and psychosocial (Specific Level of Functioning scale, SLOF) functioning, insights into illness (Insight and Treatment Attitude Questionnaire, ITAQ), and re-hospitalization rates (number and length in six months) were measured at recruitment and at one week (Post-test 1) and 12 months (Post-test 2) after the intervention. Results: Preliminary results of MANOVA test indicated that the participants in the NPP reported significantly overall improvements on the patient outcomes [F (1, 132) = 6.12, p=0.005; Wilks' Lambda= 0.95; a large effect with partial (eta)2 = 0.39]. Post hoc Tukey's HSD test indicated that their mental state (PANSS score), attitude towards medication use (DAI score), and insight into the illness (ITAQ scores) were significantly improved and hospitalization rates (both number and length of re-admissions) were significantly reduced at both one week and 12 months after the intervention, compared with standard care. Conclusion: The results of this controlled trial can provide evidence of the effectiveness of a community-based adherence therapy for schizophrenia in improving medication adherence, mental condition and insight into the illness and its treatment. This can then result in reducing the risk of relapse and re-admission over 12 months, and hence minimize those tragic events in relation to relapse such as violence and self-harm, as well as the medical and social costs.