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Review
. 2009 Feb;60(2):157-74.
doi: 10.1176/appi.ps.60.2.157.

Psychotropic medication nonadherence among United States Latinos: a comprehensive literature review

Nicole M Lanouette  1 , David P Folsom, Andres Sciolla, Dilip V Jeste
Affiliations
Review

Psychotropic medication nonadherence among United States Latinos: a comprehensive literature review

Nicole M Lanouette et al. Psychiatr Serv. 2009 Feb.

Abstract

Objective: Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. The authors systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, and mood stabilizer nonadherence among U.S. Latinos.

Methods: MEDLINE and PsycINFO were searched by using the keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms; bibliographies from relevant reviews and studies were also searched. Twenty-one studies met inclusion criteria: published since 1980 in English or Spanish and measured psychotropic medication nonadherence rates among U.S. Latino adults. Information was extracted about study design and objective, location, population, medication type, participant demographic characteristics, adherence measures, adherence rates, and factors related to adherence.

Results: In the 17 studies that included Latinos and other minority groups, mean nonadherence rates were 41%, 31%, and 43%, respectively, among Latinos, Euro-Americans, and African Americans, with an overall effect size of .64 between Latinos and Euro-Americans. In the four studies that included only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found that Latinos had significantly lower adherence rates than Euro-Americans. Risk factors for nonadherence included being a monolingual Spanish speaker, lacking health insurance, experiencing access barriers to high-quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy.

Conclusions: Rates of nonadherence to psychotropic medications were found to be higher for Latinos than for Euro-Americans. Further investigation is needed to understand the potentially modifiable individual and society-level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.

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References

    1. Ascher-Svanum H, Faries DE, Zhu B, et al. Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. Journal of Clinical Psychiatry. 2006;67:453–460. - PubMed
    1. Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Schizophrenia Bulletin. 1995;21:419–429. - PubMed
    1. Valenstein M, Copeland LA, Blow FC, et al. Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Medical Care. 2002;40:630–639. - PubMed
    1. Terkelsen KG, Menikoff A. Measuring the costs of schizophrenia. Implications for the post-institutional era in the US. Pharmacoeconomics. 1995;8:199–222. - PubMed
    1. Gilbert PL, Harris MJ, McAdams LA, et al. Neuroleptic withdrawal in schizophrenic patients. A review of the literature. Archives of General Psychiatry. 1995;52:173–188. - PubMed

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