Effect of a medication management training package for nurses on clinical outcomes for patients with schizophrenia: cluster randomised controlled trial

Abstract

Background: Non-compliance attenuates the efficacy of treatments for physical and mental disorders.

Aims: To assess the effectiveness of a medication management training package for community mental health nurses (CMHNs) in improving compliance and clinical outcomes in patients with schizophrenia.

Method: Pragmatic randomised controlled trial. Sixty CMHNs in geographical clusters were assigned randomly to medication management training or treatment as usual. Each CMHN identified two patients on their case-load who were assessed at baseline and again after 6 months by a research worker. The primary efficacy outcome of interest was psychopathology, measured using the Positive and Negative Syndrome Scale (PANSS).

Results: Nurses who had received medication management training produced a significantly greater reduction in patients'overall psychopathology compared with treatment as usual at the end of the 6-month study period (change in PANSS total scores: medication management -16.62, treatment as usual 1.17; difference -17.79; 95% CI -24.12 to -11.45; P<0.001).

Conclusions: Medication management training for CMHNs is effective in improving clinical outcomes in patients with schizophrenia.