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Characteristics associated with self-reported medication adherence in persons with psychosis referred to psychosocial rehabilitation centers

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Abstract

The aim of the present study was to explore the characteristics of psychotropic treatment and of psychosocial functioning associated with self-reported medication adherence in persons with psychosis engaged in rehabilitation. The study was performed in the REHABase cohort including persons referred to a French network of psychosocial rehabilitation centers. Treatment adherence was assessed using the Medication Adherence Rating Scale (MARS). The associations between MARS score (categorized as “low” < 7 vs. “high” ≥ 7) and functioning or psychotropic treatment characteristics were explored using multivariate analyses in 326 participants with schizophrenia spectrum disorders. Regarding psychotropic treatment, high anticholinergic load was the only characteristic associated with poor medication adherence (adjusted OR, aOR 1.98, 95% CI 1.07–3.66). Regarding functioning measures, participants with poor medication adherence were more likely to present with lower stage of recovery (aOR 2.38, 95% CI 1.31–4.32), poor quality of life (aOR 2.17, 95% CI 1.27–3.71), mental well-being (aOR 1.68, 95% CI 1.03–2.72) and self-esteem (aOR 1.74, 95% CI 1.05–2.87), and higher internalized stigma (aOR 1.88, 95% CI 1.09–3.23). Self-reported poor medication adherence is a marker of poor functioning in persons with psychosis. The MARS is a quick and simple measure of adherence that may be helpful in clinical and rehabilitation settings to identify persons with specific rehabilitation needs.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

The authors thank all the members of the REHABase Network for their help in data collection and Ray Cooke for supervising the English of this manuscript.

Funding

This work was funded by Auvergne-Rhône-Alpes and Nouvelle-Aquitaine Regional Health Agencies.

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Authors and Affiliations

  1. Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, 33000, Bordeaux, France

    Hélène Verdoux

  2. Centre Référent de Réhabilitation Psychosociale (C2RP), Centre Hospitalier Charles Perrens, 33000, Bordeaux, France

    Hélène Verdoux & Clélia Quiles

  3. Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université Claude Bernard, Lyon 1, Lyon, France

    Laura Bon, Julien Plasse & Nicolas Franck

  4. Centre Référent Conjoint de Réhabilitation (CRCR), Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France

    Isabelle Chéreau-Boudet

  5. Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère/Réseau Handicap Psychique, St Martin d’Hères, France

    Julien Dubreucq

  6. ReHPSY, Centre Hospitalier Alpes Isère, Grenoble, France

    Julien Dubreucq

  7. CREATIV & URC Pierre Deniker, Centre Hospitalier Laborit, Poitiers, France

    Emilie Legros-Lafarge

  8. Centre Référent de Réhabilitation Psychosociale de Limoges (C2RL), Limoges, France

    Nathalie Guillard-Bouhet

  9. REHALise, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France

    Catherine Massoubre

  10. Pôle Centre rive gauche, Centre Hospitalier Le Vinatier, Lyon, France

    Nicolas Franck

  11. Hôpital Charles Perrens, 121 rue de la Bechade, 33076, Bordeaux Cedex, France

    Hélène Verdoux

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  1. Hélène Verdoux
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Contributions

HV, NF, and JP made substantial contributions to the conception or design of the work. HV and JP undertook the statistical analysis. HV wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript. All authors agreed to be accountable for all aspects of the work by ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Hélène Verdoux.

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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The study obtained the authorizations required under French legislation (French National Advisory Committee for the Treatment of Information in Health Research, 16.060bis; French National Computing and Freedom Committee, DR-2017-268).

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Verdoux, H., Quiles, C., Bon, L. et al. Characteristics associated with self-reported medication adherence in persons with psychosis referred to psychosocial rehabilitation centers. Eur Arch Psychiatry Clin Neurosci 271, 1415–1424 (2021). https://doi.org/10.1007/s00406-020-01207-x

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