NYMC Faculty Publications

Treatment Adherence in Schizophrenia: A Patient-Level Meta-Analysis of Combined CATIE and EUFEST Studies

Author Type(s)

Faculty

DOI

10.1016/j.euroneuro.2015.04.003

Journal Title

European Neuropsychopharmacology

First Page

1158

Last Page

1166

Document Type

Article

Publication Date

8-1-2015

Department

Psychiatry and Behavioral Sciences

Keywords

Antipsychotic Agents, Humans, Medication Adherence, Randomized Controlled Trials as Topic, Schizophrenia, Schizophrenic Psychology, Drug Monitoring

Disciplines

Medicine and Health Sciences

Abstract

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׳ 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׳ insight and comorbid substance use and the establishment of therapeutic alliance.

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