Search

Background: Poor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control. Adherence therapy (AT) is an intervention that seeks to reduce patients' psychiatric symptoms by enhancing treatment adherence. We aimed to systematically review the trial evidence of the effectiveness of AT on improving clinical outcomes in these patients., Method: Systematic review and meta-analysis of published RCTs. We included studies testing AT as an adjunct intervention against treatment as usual or a comparator intervention in the general adult psychiatric population. The primary outcome of interest was improvement in psychiatric symptoms., Results: We included six studies testing AT in schizophrenia spectrum disorders published since 2006. A meta-analysis showed AT significantly reduced psychiatric symptoms compared to usual treatment over a follow-up period of less than 1 year. We found no significant effects of AT on patients' adherence and adherence attitudes., Conclusions: AT is an effective adjunctive treatment for people with schizophrenia spectrum disorders., Prospero: CRD42015016779.

Background: Up to 50% of patients with schizophrenia are non-adherent with antipsychotic medication., Aims: To establish the efficacy of adherence therapy (AT) compared to treatment as usual (TAU) in improving clinical outcomes in patients with schizophrenia following an acute exacerbation of illness., Method: A parallel-group, single-blind, randomised controlled trial. Fieldwork was conducted in Thailand. Patients received eight weekly sessions of AT in addition to TAU. The primary outcome was improvement in psychopathology (measured using the Positive and Negative Syndrome Scale (PANSS)) at 26-week follow-up. Secondary outcomes included patient attitudes towards medication, global functioning and side-effects., Results: In total, 70 inpatients with schizophrenia were recruited to the trial. At 26-week follow-up, PANSS total scores improved in the AT compared to the TAU group by a mean of -3.94 points (effect size = 0.24). The number needed to treat (NNT) was 5. There was no significant effect on patients' attitudes towards treatment, functioning or medication side-effects. No treatment-related adverse effects were reported., Conclusion: AT improves psychopathology in Asian patients with schizophrenia following an acute exacerbation of illness., (© The Author(s) 2014.)