Non-Pharmacological Strategies to Enhance Adherence and Continuity of Care in Schizophrenia

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Abstract

Nonadherence is highly prevalent in schizophrenia. It has been estimated that nonadherence rate for prescribed antipsychotic medications is about 50 %. Nonadherence with antipsychotic medication is a major cause of relapse and it is associated with poorer functional outcomes in patients with schizophrenia. After identifying factors that may be contributing to a patient’s adherence, it is important for clinicians to initiate strategies specifically targeted to those problems. Research has increasingly focused on psychosocial and pharmacological interventions to improve outcomes in patients with schizophrenia. Systematic reviews of various psychosocial approaches to enhance adherence to medication in schizophrenia indicate that some approaches have yielded some promising results, but they are still controversial or preliminary. The aim of this chapter is to provide a comprehensive overview of the available data on nonpharmacological strategies designed to improve adherence to medication in schizophrenia. Interventions and strategies proposed and/or tested to enhance adherence to antipsychotic medication are systematically described and discussed.

Keywords

Schizophrenia Adherence Psychoeducation Cognitive-behavioral therapy Environmental supports 
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References

  1. 1.
    Clayton CD, Veach J, Macfadden W et al (2010) Assessment of clinician awareness of non-adherence using a new structured rating scale. Psychiatr Pract 16(3):164–169Google Scholar
  2. 2.
    Tandon R, Nasrallah HA, Keshavan MS (2010) Schizophrenia, “just the facts” 5. Treatment and prevention. Past, present, and future. Schizophr Res 122(1–3):1–23PubMedGoogle Scholar
  3. 3.
    Goff DC, Hill M, Freudenreich O (2010) Strategies for improving treatment adherence in schizophrenia and schizoaffective disorder. J Clin Psychiatry 71(Suppl 2):20–26PubMedGoogle Scholar
  4. 4.
    Ascher-Svanum H, Faries DE, Zhu B et al (2006) Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry 67(3):453–460PubMedGoogle Scholar
  5. 5.
    Valenstein M, Copeland LA, Blow FC et al (2002) Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care 40:630–639PubMedGoogle Scholar
  6. 6.
    Gilmer TP, Dolder CR, Lacro JP et al (2004) Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry 161:692–699PubMedGoogle Scholar
  7. 7.
    Weiden PJ, Olfson M (1995) Cost of relapse in schizophrenia. Schizophr Bull 21(3):419–429PubMedGoogle Scholar
  8. 8.
    Dolder CR, Lacro JP, Leckband S et al (2003) Interventions to improve antipsychotic medication adherence: review of recent literature. J Clin Psychopharmacol 23:389–399PubMedGoogle Scholar
  9. 9.
    Julius RJ, Novitsky MA Jr, Dubin WR (2009) Medication adherence: a review of the literature and implications for clinical practice. J Psychiatr Pract 15(1):34–44PubMedGoogle Scholar
  10. 10.
    Velligan DI, Weiden PJ, Sajatovic M et al (2009) The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. expert consensus panel on adherence problems in serious and persistent mental illness. J Clin Psychiatry 70 (Suppl 4):1–46Google Scholar
  11. 11.
    Hardeman SM, Harding RK, Narasimhan M (2010) Simplifying adherence in schizophrenia. Psychiatr Serv 61(4):405–408PubMedGoogle Scholar
  12. 12.
    McCann TV, Boardman G, Clark E et al (2008) Risk profiles for non-adherence to antipsychotic medications. J Psychiatr Ment Health Nurs 15(8):622–629PubMedGoogle Scholar
  13. 13.
    Scott J (1999) Cognitive and behavioural approaches to medication adherence. Adv Psych Treat 5:338–347Google Scholar
  14. 14.
    Saykin AJ, Gur RC, Gur RE et al (1991) Neuropsychological function in schizophrenia: selective impairment in memory and learning. Arch Gen Psychiatry 48:618–624PubMedGoogle Scholar
  15. 15.
    Liddle PF (1987) Schizophrenic syndromes, cognitive performance and neurological dysfunction. Psych Med 17:49–57Google Scholar
  16. 16.
    Heaton R, Paulsen JS, McAdams LA et al (1994) Neuropsychological deficits in schizophrenics: relationship to age, chronicity, and dementia. Arch Gen Psychiatry 51:469–476PubMedGoogle Scholar
  17. 17.
    Barkhof E, Meijer CJ, de Sonneville LM et al (2012) Interventions to improve adherence to antipsychotic medication in patients with schizophrenia—a review of the past decade. Eur Psychiatry 27(1):9–18PubMedGoogle Scholar
  18. 18.
    Weiden PJ, Shaw E, Mann J (1986) Causes of neuroleptic noncompliance. Psychiatr Ann 16:571–575Google Scholar
  19. 19.
    Rettenbacher MA, Hofer A, Eder U et al (2004) Compliance in schizophrenia: psychopathology, side effects, and patients’ attitudes toward the illness and medication. J Clin Psychiatry 65(9):1211–1218PubMedGoogle Scholar
  20. 20.
    Lacro J (2006) Optimizing adherence to treatment in patients with schizophrenia. Behav Healthc 26(8):38–42PubMedGoogle Scholar
  21. 21.
    Kern RS, Glynn SM, Horan WP et al (2009) Psychosocial treatments to promote functional recovery in schizophrenia. Schizophr Bull 35(2):347–361PubMedGoogle Scholar
  22. 22.
    Patterson TL, Leeuwenkamp OR (2008) Adjunctive psychosocial therapies for the treatment of schizophrenia. Schizophr Res 100(1–3):108–119PubMedGoogle Scholar
  23. 23.
    Tacchi MJ, Scott J (2005) Improving adherence in schizophrenia and bipolar disorders. Wiley, ChichesterGoogle Scholar
  24. 24.
    WHO (eds) (2003) Adherence to long-term therapies: evidence for action. WHO, GenevaGoogle Scholar
  25. 25.
    Zygmunt A, Olfson M, Boyer CA et al (2002) Interventions to improve medication adherence in schizophrenia. Am J Psychiatry 159(10):1653–1664PubMedGoogle Scholar
  26. 26.
    Kane JM (2011) Improving treatment adherence in patients with schizophrenia. J Clin Psychiatry 72(9):e28PubMedGoogle Scholar
  27. 27.
    Kane JM (2006) Review of treatments that can ameliorate nonadherence in patients with schizophrenia. J Clin Psychiatry 67(Suppl 5):9–14PubMedGoogle Scholar
  28. 28.
    Velligan DI, Diamond PM, Mintz J et al (2008) The use of individually tailored environmental supports to improve medication adherence and outcomes in schizophrenia. Schizophr Bull 34(3):483–493PubMedGoogle Scholar
  29. 29.
    Mari JJ, Streiner DL (1994) An overview of family interventions and relapse on schizophrenia: meta-analysis of research findings. Psychol Med 24(3):565–578PubMedGoogle Scholar
  30. 30.
    Pitschel-Walz G, Leucht S, Bäuml J et al (2001) The effect of family interventions on relapse and rehospitalization in schizophrenia—a meta-analysis. Schizophr Bull 27(1):73–92PubMedGoogle Scholar
  31. 31.
    Pilling S, Bebbington P, Kuipers E et al (2002) Psychological treatments in schizophrenia: I. meta-analysis of family intervention and cognitive behaviour therapy. Psychol Med 32(5):763–782PubMedGoogle Scholar
  32. 32.
    Girón M, Fernández-Yañez A, Mañá-Alvarenga S et al (2010) Efficacy and effectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study. Psychol Med 40(1):73–84PubMedGoogle Scholar
  33. 33.
    Pharoah F, Mari J, Rathbone J et al (2006) Family intervention for schizophrenia. Cochrane Database Syst Rev 18(4):CD000088Google Scholar
  34. 34.
    Lincoln TM, Wilhelm K, Nestoriuc Y (2007) Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: a meta-analysis. Schizophr Res 96(1–3):232–245PubMedGoogle Scholar
  35. 35.
    Seltzer A, Roncari I, Garfinkel P (1980) Effect of patient education on medication compliance. Can J Psychiatry 25(8):638–645PubMedGoogle Scholar
  36. 36.
    Brown CS, Wright RG, Christensen DB (1987) Association between type of medication instruction and patients’ knowledge, side effects, and compliance. Hosp Community Psychiatry 38(1):55–60PubMedGoogle Scholar
  37. 37.
    Goldman CR, Quinn FL (1988) Effects of a patient education program in the treatment of schizophrenia. Hosp Community Psychiatry 39(3):282–686PubMedGoogle Scholar
  38. 38.
    Streicker S, Amdur M, Dincin J (1986) Educating patients about psychiatric medications: failure to enhance compliance. Psychosoc Rehabil J 9:15–28Google Scholar
  39. 39.
    Maurel M, Drai D, Kaladjian A et al (2010) A randomized controlled study on the impact of pharmacoeducation on a French patient population with schizophrenic and schizoaffective disorders. Can J Psychiatry 55(5):329–337PubMedGoogle Scholar
  40. 40.
    Xia J, Merinder LB, Belgamwar MR (2011) Psychoeducation for schizophrenia. Cochrane Database Syst Rev 15(6):CD002831Google Scholar
  41. 41.
    Dixon L, McFarlane WR, Lefley H et al (2001) Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatr Serv 52(7):903–910PubMedGoogle Scholar
  42. 42.
    Xiang M, Ran M, Li S (1994) A controlled evaluation of psychoeducational family intervention in a rural Chinese community. Br J Psychiatry 165(4):544–548PubMedGoogle Scholar
  43. 43.
    Ran MS, Xiang MZ, Chan CL et al (2003) Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia–a randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol 38(2):69–75PubMedGoogle Scholar
  44. 44.
    Chan SW, Yip B, Tso S et al (2009) Evaluation of a psychoeducation program for Chinese clients with schizophrenia and their family caregivers. Patient Educ Couns 75(1):67–76PubMedGoogle Scholar
  45. 45.
    Pitschel-Walz G, Bäuml J, Bender W et al (2006) Psychoeducation and compliance in the treatment of schizophrenia: results of the Munich psychosis information project study. J Clin Psychiatry 67(3):443–452PubMedGoogle Scholar
  46. 46.
    Bäuml J, Pitschel-Walz G, Volz A et al (2007) Psychoeducation in schizophrenia: 7-year follow-up concerning rehospitalization and days in hospital in the Munich psychosis information project study. J Clin Psychiatry 68(6):854–861PubMedGoogle Scholar
  47. 47.
    Kopelowicz A, Zarate R, Wallace CJ et al (2012) The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia. Arch Gen Psychiatry 69(3):265–273PubMedGoogle Scholar
  48. 48.
    Leff J, Berkowitz R, Shavit N et al (1990) A trial of family therapy versus a relatives’ group for schizophrenia two-year follow-up. Br J Psychiatry 157:571–577PubMedGoogle Scholar
  49. 49.
    Zhang M, Wang M, Li J et al (1994) Randomised-control trial of family intervention for 78 first-episode male schizophrenic patients. An 18-month study in Suzhou Jiangsu. Br J Psychiatry 165(Suppl 24):96–102Google Scholar
  50. 50.
    Haas GL, Glick ID, Clarkin JF et al (1988) Inpatient family intervention: a randomized clinical trial. II. Results at hospital discharge. Arch Gen Psychiatry 45(3):217–224PubMedGoogle Scholar
  51. 51.
    Herz MI (1996) Psychosocial treatment. Psychiatr Ann 26:531–535Google Scholar
  52. 52.
    Pharoah F, Mari J, Rathbone J et al (2010) Family intervention for schizophrenia. Cochrane Database Syst Rev 8(12):CD000088Google Scholar
  53. 53.
    Turkington D, Kingdon D, Weiden PJ (2006) Cognitive behavior therapy for schizophrenia. Am J Psychiatry 163(3):365–373PubMedGoogle Scholar
  54. 54.
    Tai S, Turkington D (2009) The evolution of cognitive behavior therapy for schizophrenia: current practice and recent developments. Schizophr Bull 35(5):865–873PubMedGoogle Scholar
  55. 55.
    NICE (2009) Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care (update). National Institute of Clinical Excellence, LondonGoogle Scholar
  56. 56.
    Dixon LB, Dickerson F, Bellack AS et al (2010) The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophr Bull 36(1):48–70PubMedGoogle Scholar
  57. 57.
    Durham RC, Chambers JA, Power KG et al (2005) Long-term outcome of cognitive behaviour therapy clinical trials in central Scotland. Health Technol Assess 9(42):1–174PubMedGoogle Scholar
  58. 58.
    Garety PA, Fowler DG, Freeman D et al (2008) Cognitive–behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial. Br J Psychiatry 192(6):412–423PubMedGoogle Scholar
  59. 59.
    Eckman TA, Liberman RP, Phipps CC et al (1990) Teaching medication management skills to schizophrenic patients. J Clin Psychopharmacol 10(1):33–38PubMedGoogle Scholar
  60. 60.
    Boczkowski JA, Zeichner A, DeSanto NJ (1985) Neuroleptic compliance among chronic schizophrenic outpatients: an intervention outcome report. Consult Clin Psychol 53(5):666–671Google Scholar
  61. 61.
    Cramer JA, Rosenheck R (1999) Enhancing medication compliance for people with serious mental illness. J Nerv Ment Dis 187(1):53–55PubMedGoogle Scholar
  62. 62.
    Razali MS, Hasanach CL, Khan A et al (2000) Psychosocial interventions for schizophrenia. J Ment Health 9:283–289Google Scholar
  63. 63.
    Jones C, Hacker D, Cormac I et al (2012) Cognitive behaviour therapy versus other psychosocial treatments for schizophrenia. Cochrane Database Syst Rev 18(4):CD008712Google Scholar
  64. 64.
    Lecompte D, Pelc I (1996) A cognitive-behavioural program to improve compliance with medication in patients with schizophrenia. Int J Ment Health 25:51–56Google Scholar
  65. 65.
    Rollnick S, Miller WR (1995) What is motivational interviewing? Behavioural and cognitive psychotherapy. Cognit Psychother 23:325–334Google Scholar
  66. 66.
    Hayward P, Chan N, Kemp R et al (1995) Medication selfmanagement: a preliminary report on an intervention to improve medication compliance. J Ment Health 4:511–517Google Scholar
  67. 67.
    Kemp R, David A (1996) Psychological predictors of insight and compliance in psychotic patients. Br J Psychiatry 169(4):444–450PubMedGoogle Scholar
  68. 68.
    Kemp R, Hayward P, Applewhaite G et al (1996) Compliance therapy in psychotic patients: randomised controlled trial. BMJ 312(10):345–349PubMedGoogle Scholar
  69. 69.
    Kemp R, Hayward P, David A (1997) Compliance therapy manual. The Maudsley, LondonGoogle Scholar
  70. 70.
    Kemp R, Kirov G, Everitt B et al (1998) Randomised controlled trial of compliance therapy. 18-month follow-up. Br J Psychiatry 172:413–419PubMedGoogle Scholar
  71. 71.
    Gray R, Robson D, Bressington D (2002) Medication management for people with a diagnosis of schizophrenia. Nurs Times 98(47):38–40PubMedGoogle Scholar
  72. 72.
    O’Donnell C, Donohoe G, Sharkey L et al (2003) Compliance therapy: a randomised controlled trial in schizophrenia. BMJ 327(7419):834PubMedGoogle Scholar
  73. 73.
    Byerly MJ, Fisher R, Carmody T et al (2005) A trial of compliance therapy in outpatients with schizophrenia or schizoaffective disorder. J Clin Psychiatry 66(8):997–1001PubMedGoogle Scholar
  74. 74.
    McIntosh AM, Conlon L, Lawrie SM (2006) Compliance therapy for schizophrenia. Cochrane Database Syst Rev 19(3):CD003442Google Scholar
  75. 75.
    Gray R, Leese M, Bindman J et al (2006) Adherence therapy for people with schizophrenia. European multicentre randomised controlled trial. Br J Psychiatry 189:508–514PubMedGoogle Scholar
  76. 76.
    Maneesakorn S, Robson D, Gournay K et al (2007) An RCT of adherence therapy for people with schizophrenia in Chiang Mai Thailand. J Clin Nurs 16(7):1302–1312PubMedGoogle Scholar
  77. 77.
    Anderson KH, Ford S, Robson D et al (2010) An exploratory, randomized controlled trial of adherence therapy for people with schizophrenia. Int J Ment Health Nurs 19(5):340–349PubMedGoogle Scholar
  78. 78.
    Uzenoff SR, Perkins DO, Hamer RM et al (2008) A preliminary trial of adherence-coping-education (ACE) therapy for early psychosis. J Nerv Ment Dis 196(7):572–575PubMedGoogle Scholar
  79. 79.
    Staring AB, Van der Gaag M, Koopmans GT et al (2010) Treatment adherence therapy in people with psychotic disorders: randomised controlled trial. Br J Psychiatry 197(6):448–455PubMedGoogle Scholar
  80. 80.
    Becker MH, Maiman LA (1975) Sociobehavioral determinants of compliance with healthand medical care recommendations. Med Care 13:10–24PubMedGoogle Scholar
  81. 81.
    Becker MH, Maiman LA, Kirscht JP et al (1977) The health belief model and prediction of dietary compliance: a field experiment. J Health Soc Behav 18(4):348–366PubMedGoogle Scholar
  82. 82.
    Becker MH (1985) Patient adherence to prescribed therapies. Med Care 23(5):539–555PubMedGoogle Scholar
  83. 83.
    Rosenstock IM (1974) Historical origins of the health belief model. Health Educ Monogr 2:409–419Google Scholar
  84. 84.
    Marder SR, May PR (1986) Benefits and limitations of neuroleptics—and other forms of treatment—in schizophrenia. Am J Psychother 40(3):357–369PubMedGoogle Scholar
  85. 85.
    Albus M (1995) The problem of drug compliance in schizophrenic patients. Psychiatr Prax 22(6):221–222PubMedGoogle Scholar
  86. 86.
    Razali MS, Yahya H (1995) Compliance with treatment in schizophrenia: a drug intervention program in a developing country. Acta Psychiatr Scand 91(5):331–335PubMedGoogle Scholar
  87. 87.
    Johnson DA, Freeman H (1973) Drug defaulting by patients on long-acting phenothiazines. Psychol Med 3(1):115–119PubMedGoogle Scholar
  88. 88.
    Johnson DA (1977) Treatment of chronic schizophrenia. Drugs 14(4):291–299PubMedGoogle Scholar
  89. 89.
    Soskis DA (1978) Schizophrenic and medical inpatients as informed drug consumers. Arch Gen Psychiatry 35(5):645–647PubMedGoogle Scholar
  90. 90.
    Marder SR, Mebane A, Chien CP et al (1983) A comparison of patients who refuse and consent to neuroleptic treatment. Am J Psychiatry 140(4):470–472PubMedGoogle Scholar
  91. 91.
    Marder SR, Swann E, Winslade WJ et al (1984) A study of medication refusal by involuntary psychiatric patients. Hosp Community Psychiatry 35(7):724–726PubMedGoogle Scholar
  92. 92.
    Horne R, Weinman J (1998) Predicting treatment adherence: an overview of theoretical models. In: Myers LB, Midence K (eds) Adherence to treatment in medical conditions. Harwood Academic Press, Amsterdam, pp 25–50Google Scholar
  93. 93.
    Weinstein ND (1988) The precaution adoption process. Health Psychol 7:355–386PubMedGoogle Scholar
  94. 94.
    Perkins DO (2002) Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry 63(12):1121–1128PubMedGoogle Scholar
  95. 95.
    Lacro JP, Dunn LB, Dolder CR et al (2002) Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 63(10):892–909PubMedGoogle Scholar
  96. 96.
    Garavan J, Browne S, Gervin M et al (1998) Compliance with neuroleptic medication in outpatients with schizophrenia; relationship to subjective response to neuroleptics; attitudes to medication and insight. Compr Psychiatry 39(4):215–219PubMedGoogle Scholar
  97. 97.
    Velligan DI, Weiden PJ (2006) Interventions to improve adherence to antipsychotic medication. Psychiatric Times 23(9):1–2Google Scholar
  98. 98.
    Fenton WS, Blyler CR, Heinssen RK (1997) Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 23(4):637–651PubMedGoogle Scholar
  99. 99.
    Frank AF, Gunderson JG (1990) The role of the therapeutic alliance in the treatment of schizophrenia. Relationship to course and outcome. Arch Gen Psychiatry 47(3):228–236PubMedGoogle Scholar
  100. 100.
    Weiss KA, Smith TE, Hull JW et al (2002) Predictors of risk of nonadherence in outpatients with schizophrenia and other psychotic disorders. Schizophr Bull 28(2):341–349Google Scholar
  101. 101.
    Fleischhacker WW, Meise U, Günther V et al (1994) Compliance with antipsychotic drug treatment: influence of side effects. Acta Psychiatr Scand Suppl 382:11–15PubMedGoogle Scholar
  102. 102.
    Budd RJ, Hughes IC, Smith JA (1996) Health beliefs and compliance with antipsychotic medication. Br J Clin Psychol 35(3):393–397PubMedGoogle Scholar
  103. 103.
    Champion VL (1984) Instrument development for health belief model constructs. ANS Adv Nurs Sci 6(3):73–85PubMedGoogle Scholar
  104. 104.
    Pan PC, Tantam D (1989) Clinical characteristics, health beliefs and compliance with maintenance treatment: a comparison between regular and irregular attenders at a depot clinic. Acta Psychiatr Scand 79(6):564–570PubMedGoogle Scholar
  105. 105.
    Adams J, Scott J (2000) Predicting medication adherence in severe mental disorders. Acta Psychiatr Scand 101(2):119–124PubMedGoogle Scholar
  106. 106.
    Robinson DG, Woerner MG, Alvir JM et al (2002) Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder. Schizophr Res 57:209–219PubMedGoogle Scholar
  107. 107.
    Grunebaum MF, Weiden PJ, Olfson M (2001) Medication supervision and adherence of persons with psychotic disorders in residential treatment settings: a pilot study. J Clin Psychiatry 62(5):394–399PubMedGoogle Scholar
  108. 108.
    Oehl M, Hummer M, Fleischhacker WW (2000) Compliance with antipsychotic treatment. Acta Psychiatr Scand Suppl 102(407):83–86Google Scholar
  109. 109.
    Babiker IE (1986) Noncompliance in schizophrenia. Psychiatr Dev 4(4):329–337PubMedGoogle Scholar
  110. 110.
    Bebbington PE (1995) The content and context of compliance. Int Clin Psychopharmacol 9(Suppl 5):41–50PubMedGoogle Scholar
  111. 111.
    Kinderman P, Setzu E, Lobban F et al (2006) Illness beliefs in schizophrenia. Soc Sci Med 63(7):1900–1911PubMedGoogle Scholar
  112. 112.
    Velligan DI, Mueller J, Wang M et al (2006) Use of environmental supports among patients with schizophrenia. Psychiatr Serv 57(2):219–224PubMedGoogle Scholar
  113. 113.
    Velligan DI, Prihoda TJ, Ritch JL et al (2002) A randomized single-blind pilot study of compensatory strategies in schizophrenia outpatients. Schizophr Bull 28(2):283–292PubMedGoogle Scholar
  114. 114.
    Velligan DI, Bow-Thomas CC (2000) Two case studies of cognitive adaptation training for outpatients with schizophrenia. Psychiatr Serv 51(1):25–29PubMedGoogle Scholar
  115. 115.
    Velligan DI, Bow-Thomas CC, Huntzinger C et al (2000) Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatients with schizophrenia. Am J Psychiatry 157(8):1317–1323PubMedGoogle Scholar
  116. 116.
    Velligan DI, Mueller J, Wang M et al (2006) Use of environmental supports among patients with schizophrenia. Psychiatr Serv 57(2):219–224PubMedGoogle Scholar
  117. 117.
    Velligan DI, Diamond P, Mueller J et al (2009) The short-term impact of generic versus individualized environmental supports on functional outcomes and target behaviors in schizophrenia. Psychiatry Res 168(2):94–101PubMedGoogle Scholar
  118. 118.
    Valenstein M, Kavanagh J, Lee T et al (2011) Using a pharmacy-based intervention to improve antipsychotic adherence among patients with serious mental illness. Schizophr Bull 37(4):727–736PubMedGoogle Scholar
  119. 119.
    Pijnenborg GH, Withaar FK, Brouwer WH et al (2010) The efficacy of SMS text messages to compensate for the effects of cognitive impairments in schizophrenia. Br J Clin Psychol 49(Pt 2):259–274PubMedGoogle Scholar
  120. 120.
    Salzer MS, Tunner T, Charney NJ (2004) A low-cost, telephone intervention to enhance schizophrenia treatment: a demonstration study. Schizophr Res 66(1):75–76PubMedGoogle Scholar
  121. 121.
    Beebe LH, Smith K, Crye C et al (2008) Telenursing intervention increases psychiatric medication adherence in schizophrenia outpatients. J Am Psychiatr Nurses Assoc 14(3):217–224PubMedGoogle Scholar
  122. 122.
    Spaniel F, Vohlídka P, Hrdlicka J et al (2008) ITAREPS: information technology aided relapse prevention programme in schizophrenia. Schizophr Res 98(1–3):312–317PubMedGoogle Scholar
  123. 123.
    Kurtz MM, Baker E, Pearlson GD et al (2007) A virtual reality apartment as a measure of medication management skills in patients with schizophrenia: a pilot study. Schizophr Bull 33(5):1162–1170PubMedGoogle Scholar
  124. 124.
    Janssen B, Ludwig S, Eustermann H et al (2010) Improving outpatient treatment in schizophrenia: effects of computerized guideline implementation—results of a multicenter-study within the German research network on schizophrenia. Eur Arch Psychiatry Clin Neurosci 260(1):51–57PubMedGoogle Scholar
  125. 125.
    Marshall M, Lockwood A (2000) Assertive community treatment for people with severe mental disorders. Cochrane Database Syst Rev 2:CD001089Google Scholar
  126. 126.
    Marshall M, Gray A, Lockwood A et al (2000) Case management for people with severe mental disorders. Cochrane Database Syst Rev 2:CD000050Google Scholar
  127. 127.
    Bond GR, McGrew JH, Fekete DM (1995) Assertive outreach for frequent users of psychiatric hospitals: a meta-analysis. J Ment Health Adm 22(1):4–16PubMedGoogle Scholar
  128. 128.
    Coldwell CM, Bender WS (2007) The effectiveness of assertive community treatment for homeless populations with severe mental illness: a meta-analysis. Am J Psychiatry 164(3):393–399PubMedGoogle Scholar
  129. 129.
    Nelson G, Aubry T, Lafrance A (2007) A review of the literature on the effectiveness of housing and support, assertive community treatment, and intensive case management interventions for persons with mental illness who have been homeless. Am J Orthopsychiatry 77(3):350–361PubMedGoogle Scholar
  130. 130.
    Burns T, Catty J, Dash M et al (2007) Use of intensive case management to reduce time in hospital in people with severe mental illness: systematic review and meta-regression. BMJ:335(7615):336Google Scholar
  131. 131.
    Stein LI, Test MA (1980) Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation. Arch Gen Psychiatry 37(4):392–397PubMedGoogle Scholar
  132. 132.
    Ford R, Beadsmore A, Ryan P et al (1995) Providing the safety net: case management for people with serious mental illness. J Ment Health 1:91–97Google Scholar
  133. 133.
    Bond GR, Miller LD, Krumwied RD et al (1988) Assertive case management in three CMHCs: a controlled study. Hosp Community Psychiatry 39(4):411–418PubMedGoogle Scholar
  134. 134.
    Solomon P, Draine J (1995) The efficacy of a consumer case management team: 2-year outcomes of a randomized trial. J Ment Health Adm 22(2):135–146PubMedGoogle Scholar
  135. 135.
    Dixon L, Weiden P, Torres M et al (1997) Assertive community treatment and medication compliance in the homeless mentally ill. Am J Psychiatry 154(9):1302–1304PubMedGoogle Scholar
  136. 136.
    McEvoy JP, Scheifler PL, Frances A et al (1999) The expert consensus guideline series: treatment of schizophrenia. J Clin Psychiatry 60(Suppl 11):3–80Google Scholar
  137. 137.
    Gray R, Wykes T, Gournay K (2003) The effect of medication management training on community mental health nurse’s clinical skills. Int J Nurs Stud 40(2):163–169PubMedGoogle Scholar
  138. 138.
    Gray R, Wykes T, Edmonds M et al (2004) Effect of a medication management training package for nurses on clinical outcomes for patients with schizophrenia: cluster randomised controlled trial. Br J Psychiatry 185:157–162PubMedGoogle Scholar
  139. 139.
    Hudson TJ, Owen RR, Thrush CR et al (2008) Guideline implementation and patient-tailoring strategies to improve medication adherence for schizophrenia. J Clin Psychiatry 69(1):74–80PubMedGoogle Scholar
  140. 140.
    Linden M, Pyrkosch L, Hundemer HP (2008) Frequency and effects of psychosocial interventions additional to olanzapine treatment in routine care of schizophrenic patients. Soc Psychiatry Psychiatr Epidemiol 43(5):373–379PubMedGoogle Scholar
  141. 141.
    Guo X, Zhai J, Liu Z et al (2010) Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: a randomized, 1-year study. Arch Gen Psychiatry 67(9):895–904PubMedGoogle Scholar
  142. 142.
    Misdrahi D, Petit M, Blanc O et al (2012) The influence of therapeutic alliance and insight on medication adherence in schizophrenia. Nord J Psychiatry 66(1):49–54PubMedGoogle Scholar
  143. 143.
    Deegan PE, Drake RE (2006) Shared decision making and medication management in the recovery process. Psychiatr Serv 57(11):1636–1639PubMedGoogle Scholar
  144. 144.
    Drake RE, Deegan PE, Rapp C (2010) The promise of shared decision making in mental health. Psychiatr Rehabil J 34(1):7–13PubMedGoogle Scholar
  145. 145.
    Mistler LA, Drake RE (2008) Shared decision making in antipsychotic management. J Psychiatr Pract 14(6):333–344PubMedGoogle Scholar
  146. 146.
    Perkins DO, Gu H, Weiden PJ et al (2008) Predictors of treatment discontinuation and medication nonadherence in patients recovering from a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder: a randomized, double-blind, flexible-dose, multicenter study. J Clin Psychiatry 69(1):106–113PubMedGoogle Scholar
  147. 147.
    Kelly GR, Scott JE, Mamon J (1990) Medication compliance and health education among outpatients with chronic mental disorders. Med Care 28(12):1181–1197PubMedGoogle Scholar
  148. 148.
    Hogarty GE, Anderson CM, Reiss DJ et al (1991) Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Environmental-Personal Indicators in the Course of Schizophrenia (EPICS) research group. Arch Gen Psychiatry 48(4):340–347PubMedGoogle Scholar
  149. 149.
    Guimon L, Eguiluz I, Bulbena A (1993) Group pharmacotherapy in schizophrenics: attitudinal and clinical changes. Eur J Psychiatry 7(3):147–154Google Scholar
  150. 150.
    Azrin NH, Teichner G (1998) Evaluation of an instructional program for improving medication compliance for chronically mentally ill outpatients. Behav Res Ther 36(9):849–861PubMedGoogle Scholar
  151. 151.
    Petersen L, Jeppesen P, Thorup A et al (2005) A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness. BMJ 331(7517):602PubMedGoogle Scholar
  152. 152.
    Masand PS, Narasimhan M (2006) Improving adherence to antipsychotic pharmacotherapy. Curr Clin Pharmacol 1(1):47–56PubMedGoogle Scholar
  153. 153.
    Valencia M, Rascon ML, Juarez F et al (2007) A psychosocial skills training approach in Mexican out-patients with schizophrenia. Psychol Med 37(10):1393–1402PubMedGoogle Scholar
  154. 154.
    Morken G, Grawe RW, Widen JH (2007) Effects of integrated treatment on antipsychotic medication adherence in a randomized trial in recent-onset schizophrenia. J Clin Psychiatry 68(4):566–571PubMedGoogle Scholar
  155. 155.
    Haynes RB, Ackloo E, Sahota N et al (2008) Interventions for enhancing medication adherence. Cochrane Database Syst Rev 16(2):CD000011Google Scholar
  156. 156.
    Beck EM, Cavelti M, Kvrgic S et al (2011) Are we addressing the ‘right stuff’ to enhance adherence in schizophrenia? Understanding the role of insight and attitudes towards medication. Schizophr Res 132(1):42-49Google Scholar
  157. 157.
    Kikkert MJ, Schene AH, Koeter MW et al (2006) Medication adherence in schizophrenia: exploring patients’, carers’ and professionals’ views. Schizophr Bull 32(4):786–794PubMedGoogle Scholar
  158. 158.
    Rüsch N, Todd AR, Bodenhausen GV et al (2009) Implicit versus explicit attitudes toward psychiatric medication: Implications for insight and treatment adherence. Schizophr Res 112(1–3):119–122PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Antonio Vita
    • 2
  • Stefano Barlati
    • 3
  • Emilio Sacchetti
    • 1
  1. 1.Department of Clinical and Experimental Sciences, Neuroscience Section, Brescia University School of Medicine Psychiatric Unit 22, Brescia University and Brescia Spedali Civili Psychiatric Clinic, Brescia University and Brescia Spedali CiviliDepartment of Mental HealthBresciaItaly
  2. 2.Department of Clinical and Experimental Sciences, Neuroscience Section, Brescia University School of Medicine Psychiatric Unit 20, Brescia University and Brescia Spedali CiviliDepartment of Mental HealthBresciaItaly
  3. 3.Psychiatric Unit 20, Brescia University and Brescia Spedali CiviliDepartment of Mental HealthBresciaItaly

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