Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec 7;18(5):pyu091.
doi: 10.1093/ijnp/pyu091.

Measuring adherence to medication in schizophrenia: the relationship between attitudes toward drug therapy and plasma levels of new-generation antipsychotics

Nursen Yalcin-Siedentopf  1 , Fabienne Wartelsteiner  1 , Alexandra Kaufmann  1 , Falko Biedermann  1 , Monika Edlinger  1 , Georg Kemmler  1 , Maria A Rettenbacher  1 , Christian G Widschwendter  1 , Gerald Zernig  1 , W Wolfgang Fleischhacker  1 , Alex Hofer  2
Affiliations

Measuring adherence to medication in schizophrenia: the relationship between attitudes toward drug therapy and plasma levels of new-generation antipsychotics

Nursen Yalcin-Siedentopf et al. Int J Neuropsychopharmacol. .

Abstract

Background: Nonadherence to medication is still a major problem in the treatment of schizophrenia. The current longitudinal study investigated whether the patients' attitudes toward treatment correlated with the ratio of observed vs expected plasma levels of antipsychotic drugs as an objective measurement of adherence.

Methods: Data of patients starting monotherapy with a new-generation antipsychotic were collected 2, 4, and 12 weeks after the initiation of treatment. Next to the assessment of patients' attitudes toward medication by means of the Drug Attitude Inventory, the ratio of the observed vs expected plasma level was calculated. Antipsychotic-induced side effects were evaluated by means of the Udvalg for Kliniske Undersogelser Side Effect Rating Scale.

Results: A total of 93 patients were eligible for statistical analysis. About one-half of the ratios of observed vs expected plasma levels ranged from 0.5 to 2 and were considered normal, whereas the other ratios were considered either too low (<0.5) or too high (>2). No consistent correlation between patients' attitude toward drug therapy and the individual ratios of observed vs expected plasma levels of medication was detected. This finding was not affected by side effects.

Conclusions: Our results highlight the importance of recognizing the complex nature of adherence to medication in schizophrenia patients. Importantly, we found no consistent correlation between subjective and objective measures of medication adherence. Therefore, monitoring adherence to medication remains a challenge in clinical practice.

Keywords: adherence; drug attitude; ratio; schizophrenia; therapeutic drug monitoring.

PubMed Disclaimer

References

    1. Acosta FJ, Hernández JL, Pereira J, Herrera J, Rodríguez CJ. (2012). Medication adherence in schizophrenia. World J Psychiatry 2:74–82. - PMC - PubMed
    1. Brain C, Allerby K, Sameby B, Quinlan P, Joas E, Karilampi U, Lindström E, Eberhard J, Burns T, Waern M. (2013). Drug attitude and other predictors of medication adherence in schizophrenia: 12 months of electronic monitoring (MEMS®) in the Swedish COAST-study. Eur Neuropsychopharmacol 23:1754–1762. - PubMed
    1. Brunton LL, Lazo JS, Parker KL, eds (2006). Goodman & Gilman’s The pharmacological basis of therapeutics. New York: McGraw-Hill.
    1. Cañas F, Alptekin K, Azorin JM, Dubois V, Emsley R, García AG, Gorwood P, Haddad PM, Naber D, Olivares JM, Papageorgiou G, Roca M. (2013). Improving treatment adherence in your patients with schizophrenia: the STAY initiative. Clin Drug Investig 33:97–107. - PubMed
    1. Crespo JA, Sturm K, Saria A, Zernig G. (2005). Simultaneous intra-accumbens remifentanil and dopamine kinetics suggest that neither determines within-session operant responding. Psychopharmacology 183:201–209. - PubMed

Substances