TY - JOUR
T1 - Treatment adherence in schizophrenia
T2 - A patient-level meta-analysis of combined CATIE and EUFEST studies
AU - Czobor, Pál
AU - Van Dorn, Richard A.
AU - Citrome, Leslie
AU - Kahn, Rene S.
AU - Fleischhacker, W Wolfgang
AU - Volavka, Jan
PY - 2015/8/1
Y1 - 2015/8/1
N2 - The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients[U+05F3] data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p = 0.0003), higher levels of hostility (p = 0.0002), and impaired insight (p < 0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients[U+05F3] insight and comorbid substance use and the establishment of therapeutic alliance.
AB - The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients[U+05F3] data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p = 0.0003), higher levels of hostility (p = 0.0002), and impaired insight (p < 0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients[U+05F3] insight and comorbid substance use and the establishment of therapeutic alliance.
KW - Adherence
KW - Antipsychotic
KW - Compliance
KW - Hostility
KW - Insight
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=84938746749&partnerID=8YFLogxK
U2 - 10.1016/j.euroneuro.2015.04.003
DO - 10.1016/j.euroneuro.2015.04.003
M3 - Article
C2 - 26004980
AN - SCOPUS:84938746749
SN - 0924-977X
VL - 25
SP - 1158
EP - 1166
JO - European Neuropsychopharmacology
JF - European Neuropsychopharmacology
IS - 8
ER -