Study of factors affecting drug compliance in schizophrenia- cross sectional survey
Keywords:
Drug compliance, Schizophrenia, Delusions, Insight
Abstract
Introduction: Schizophrenia is a condition characterized by delusions, hallucinations, disorganized behavior, disorganized thought, and negative symptoms. There is overwhelming evidence that antipsychotics can be effective in treating the symptoms of schizophrenia. Approximately 75% of individuals relapse without drugs compared to 25% with drug. Patients who receive long-acting depot have lower relapse rates than patients who receive oral medications. The factors affecting drug compliance include side effects, psychopathology, social support, and insight. Indian studies are comparatively few in this area; knowledge of these factors can help in formulating strategies for enhancing drug compliance and outcome.
Methods: This study was conducted at the Department of Psychiatry T D Medical College, Alleppey, a tertiary care teaching hospital. Patients who attended the Outpatient department were assessed with following instruments, Positive and negative symptom scale, Udvalg Klinske Undersogelser Side Effect Rating Scale, Multidimensional scale of perceived social support, Scale to assess Unawareness of Mental Disorder (SUMD), Compliance was assessed by using the criteria of fully compliant defined as those miss less than 20% of medication, partially compliant those who misses 20% to 80% of medication and noncompliant those who miss more than 80% of medicines. Data was analysed using Chi square test and regression analysis.
Result: Sex, Education status, marital status, Occupation, and drugs administered had significant relationships with Compliance.
Conclusion:, it is advisable to use minimum number of drugs for ensuring compliance.
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References
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33. Irwin DS, Weitzel WD, Morgan DW. Phenothiazine intake and staff attitudes. Am J Psychiatry. 1971 Jun;127(12):1631-5. [PubMed]
34. Tamminga CA, Schulz SC. Schizophrenia Research: Advances in Neuropsychiatry and Psychopharmacology, vol 1. New York, NY: Raven Press;1991.
35. Van Putten T, May PR, Marder SR. Akathisia with haloperidol and thiothixene. Arch Gen Psychiatry. 1984 Nov;41(11):1036-9. [PubMed]
36. Hummer M, Kemmler G, Kurz M, Kurzthaler I, Oberbauer H, Fleischhacker WW. Sexual disturbances during clozapine and haloperidol treatment for schizophrenia. Am J Psychiatry.1999 Apr;156(4):631-3. [PubMed]
37. Van Putten T. Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry. 1974 Jul; 31(1):67-72. [PubMed]
38. Van Putten T, May PR, Marder SR, Wittmann LA. Subjective response to antipsychotic drugs. Arch Gen Psychiatry. 1981 Feb;38(2):187-90. [PubMed]
39. Grunebaum MF, Weiden PJ, Olfson M. Medication supervision and adherence of persons with psychotic disorders in residential treatment settings: a pilot study [CME]. J Clin Psychiatry 2001;62:394–399.
2. Thornley B, Adams C. Content and quality of 2000 controlled trials in schizophrenia over 50 years. BMJ. 1998 Oct 31;317(7167):1181-4. [PubMed]
3. Haynes RB, Sackett DL. Compliance in Health Care. Baltimore, Md: Johns Hopkins Press; 1979.
4. Amador XF, Flaum M, Andreasen NC, Strauss DH, Yale SA, Clark SC, Gorman JM. Awareness of illness in schizophrenia and schizoaffective and mood disorders. Arch Gen Psychiatry.1994Oct;51(10):826-36. [PubMed]
5. Irwin DS, Weitzel WD, Morgan DW. Phenothiazine intake and staff attitudes. Am J Psychiatry. 1971 Jun; 127(12):1631-5. [PubMed]
6. Van Putten T, May PR, Marder SR. Akathisia with haloperidol and thiothixene. Arch Gen Psychiatry. 1984 Nov; 41(11):1036-9. [PubMed]
7. Hudson TJ, Owen RR, Thrush CR, Han X, Pyne JM, Thapa P, Sullivan G. A pilot study of barriers to medication adherence in schizophrenia. J Clin Psychiatry. 2004 Feb;65(2):211-6. [PubMed]
8. Fleischhacker WW, Meise U, Günther V, Kurz M. Compliance with antipsychotic drug treatment: influence of side effects. Acta Psychiatr Scand Suppl. 1994;382:11-5. [PubMed]
9. Cramer JA, Rosenheck R. Compliance with medication regimens for mental and physical disorders. Psychiatr Serv. 1998 Feb;49(2):196-201. [PubMed]
10. Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings.Schizophr Bull.1997;23(4):637-51. [PubMed]
11. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261-76. [PubMed]
12. Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K: The UKU side effect rating scale: a new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptictreate patients. Acta Psychiatr Scand Suppl. 1987, 334:1-100. [PubMed]
13. Gregory D. Zimet, Nancy W. Dahlem, Sara G. Zimet & Gordon K. Farley. The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment.Volume 52, Issue 1, 1988, 30-41.
14. Amador XF, Strauss DH, Yale SA, Flaum MM, Endicott J, Gorman JM. Assessment of insight in psychosis. Am J Psychiatry. 1993 Jun;150(6):873-9. [PubMed]
15. Di Matteo MR, Di Nicola DD. Achieving Patient Compliance. New York, NY: Pergamon Press; 1982.
16. SCHWARTZ D, WANG M, ZEITZ L, GOSS ME. Medication errors made by elderly, chronically ill patients. Am J Public Health Nations Health. 1962 Dec;52:2018-29. [PubMed]
17. Riecher-Rössler A. Geschlechtsunterschiede bei Schizophrenien. Presented at the 3rd Congress“Psychiatrische Erkrankungen bei Frauen”; Nov 4–6,1999; Basel, Switzerland
18. Byerly M, Fisher R, Rush AJ, et al. A comparison of clinician vs. electronic monitoring of antipsychotic adherence in schizophrenia [poster] Presented at the 41st annual meeting of the American College of Neuropsychopharmacology; Dec 10, 2002; San Juan,Puerto Rico.
19. Young JL, Zonana HV, Shepler L. Medication noncompliance in schizophrenia: codification and update. Bull Am Acad Psychiatry Law.1986;14(2): 105-22.
20. Docherty JP, Grogg AL, Kozma C, et al. Antipsychotic maintenance in schizophrenia: partial compliance and clinical outcome [poster]. Presented at the 41st annual meeting of the American College of Neuropsychopharmacology; Dec 8–12, 2002; San Juan, Puerto Rico.
21. Eisen SA, Miller DK, Woodward RS, Spitznagel E, Przybeck TR. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med. 1990 Sep;150(9):1881-4. [PubMed]
22. Schou M. The combat of non-compliance during prophylactic lithium treatment. Acta Psychiatr Scand. 1997 May;95(5):361-3. [PubMed]
23. Miner CR, Rosenthal RN, Hellerstein DJ, Muenz LR. Prediction of compliance with outpatient referral in patients with schizophrenia and psychoactive substance use disorders. Arch Gen Psychiatry. 1997 Aug; 54(8):706-12. [PubMed]
24. Tattan TM, Creed FH. Negative symptoms of schizophrenia and compliance with medication. Schizophr Bull. 2001;27(1):149-55. [PubMed]
25. Drake RE, Osher FC, Wallach MA. Alcohol use and abuse in schizophrenia. A prospective community study. J Nerv Ment Dis. 1989 Jul;177(7):408-14. [PubMed]
26. Kashner TM, Rader LE, Rodell DE, et al. Family characteristics, substance abuse and hospitalization patterns of patients with schizophrenia.Hosp Community Psychiatry 1991;42:195–197. [PubMed]
27. Owen RR, Fischer EP, Booth BM, Cuffel BJ. Medication noncompliance and substance abuse among patients with schizophrenia. Psychiatr Serv. 1996 Aug;47(8):853-8. [PubMed]
28. Van Putten T. Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry. 1974 Jul;31(1):67-72. [PubMed]
29. Corriss DJ, Smith TE, Hull JW, et al. Interactive risk factors for treatment adherence in a chronic psychotic disorders population. Psychiatry Res 1999; 89:269–274.
30. Marder SR, Mebane A, Chien CP, Winslade WJ, Swann E, Van Putten T. A comparison of patients who refuse and consent to neuroleptic treatment. Am J Psychiatry. 1983 Apr;140(4):470-2. [PubMed]
31. Pyne JM, Bean D, Sullivan G. Characteristics of patients with schizophrenia who do not believe they are mentally ill. J Nerv Ment Dis. 2001 Mar;189(3):146-53. [PubMed]
32. Adams J, Scott J. Predicting medication adherencein severe mental disorders. Acta Psychiatr Scand. 2000 Feb;101(2):119-24. [PubMed]
33. Irwin DS, Weitzel WD, Morgan DW. Phenothiazine intake and staff attitudes. Am J Psychiatry. 1971 Jun;127(12):1631-5. [PubMed]
34. Tamminga CA, Schulz SC. Schizophrenia Research: Advances in Neuropsychiatry and Psychopharmacology, vol 1. New York, NY: Raven Press;1991.
35. Van Putten T, May PR, Marder SR. Akathisia with haloperidol and thiothixene. Arch Gen Psychiatry. 1984 Nov;41(11):1036-9. [PubMed]
36. Hummer M, Kemmler G, Kurz M, Kurzthaler I, Oberbauer H, Fleischhacker WW. Sexual disturbances during clozapine and haloperidol treatment for schizophrenia. Am J Psychiatry.1999 Apr;156(4):631-3. [PubMed]
37. Van Putten T. Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry. 1974 Jul; 31(1):67-72. [PubMed]
38. Van Putten T, May PR, Marder SR, Wittmann LA. Subjective response to antipsychotic drugs. Arch Gen Psychiatry. 1981 Feb;38(2):187-90. [PubMed]
39. Grunebaum MF, Weiden PJ, Olfson M. Medication supervision and adherence of persons with psychotic disorders in residential treatment settings: a pilot study [CME]. J Clin Psychiatry 2001;62:394–399.
CITATION
DOI: 10.17511/ijmrr.2016.i09.02
Published: 2016-09-30
How to Cite
1.
Roy Gopalan M, Vidhukumar V. Study of factors affecting drug compliance in schizophrenia- cross sectional survey. Int J Med Res Rev [Internet]. 2016Sep.30 [cited 2024Apr.20];4(9):1520-3. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/680
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Original Article
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