Does compliance therapy improve use of antipsychotic medication?

Abstract

Non-compliance with prescribed antipsychotic medication is common among people diagnosed with schizophrenia and is associated with high relapse rates. Compliance therapy is an intervention to promote compliance, developed from motivational interviewing and cognitive behavioural therapy. This mini-review aims to examine the evidence for the effect of compliance therapy on promoting compliance with antipsychotic medication, compared to usual advice. Online medical databases were searched for randomized controlled trials (RCTs) which compared a group of participants who received compliance therapy with a group who did not. Articles were only considered if the participants were on antipsychotic medication; received 4-6 sessions of compliance therapy (as defined by Kemp et al (1998)), which lasted 20-60 minutes; and an outcome measure of compliance and psychotic symptoms was given. Two RCTs met the inclusion criteria. One reported compliance therapy had a significant effect on compliance but not on symptoms. The other RCT reported no significant effects from compliance therapy. However, methodological flaws effected the validity of both findings. Further quality research is required in this important area.