Abstract:
BACKGROUND:Similar to patients with other chronic disorders, patients with serious mental illness (SMI) are often poorly adherent with prescribed medications. OBJECTIVE:We conducted a randomized controlled trial examining the effectiveness of a pharmacy-based intervention (Meds-Help) in increasing antipsychotic medication adherence among Department of Veterans Affairs (VA) patients with SMI. We also examined the impact of Meds-Help on psychiatric symptoms, quality of life, and satisfaction with care. METHODS:We enrolled 118 patients from 4 VA facilities with schizophrenia, schizoaffective, or bipolar disorder who were on long-term antipsychotics but had antipsychotic medication possession ratios (MPRs) <0.8 in the prior year. Patients were randomized to usual care (UC; n = 60) or the pharmacy-based intervention (Meds-Help; n = 58). We reassessed adherence at 6 and 12 months, at which time patients completed Positive and Negative Symptom Scales (PANSS), Quality of Well-being Scales (QWB), and Client Satisfaction Questionnaires (CSQ-8). RESULTS:Prior to enrollment, Meds-Help and UC patients had mean antipsychotic MPRs of 0.54 and 0.55, respectively. At 6 months, mean MPRs were 0.91 for Meds-Help and 0.64 for UC patients; at 12 months, they were 0.86 for Meds-Help and 0.62 for UC patients. In multivariate analyses adjusting for patient factors, Meds-Help patients had significantly higher MPRs at 6 and 12 months (P < .0001). There were no significant differences between groups in PANSS, QWB, or CSQ-8 scores, but power to detect small effects was limited. CONCLUSIONS:Congruent with prior studies of patients with other disorders, a practical pharmacy-based intervention increased antipsychotic adherence among patients with SMI. However, SMI patients may require additional care management components to improve outcomes.
journal_name
Schizophr Bulljournal_title
Schizophrenia bulletinauthors
Valenstein M,Kavanagh J,Lee T,Reilly P,Dalack GW,Grabowski J,Smelson D,Ronis DL,Ganoczy D,Woltmann E,Metreger T,Wolschon P,Jensen A,Poddig B,Blow FCdoi
10.1093/schbul/sbp121subject
Has Abstractpub_date
2011-07-01 00:00:00pages
727-36issue
4eissn
0586-7614issn
1745-1701pii
sbp121journal_volume
37pub_type
杂志文章,多中心研究,随机对照试验abstract::The variability in the response to antipsychotic medication in schizophrenia may reflect between-patient differences in neurobiology. Recent cross-sectional neuroimaging studies suggest that a poorer therapeutic response is associated with relatively normal striatal dopamine synthesis capacity but elevated anterior ci...
journal_title:Schizophrenia bulletin
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journal_title:Schizophrenia bulletin
pub_type: 共识发展会议,杂志文章,实务指引,评审
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journal_title:Schizophrenia bulletin
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journal_title:Schizophrenia bulletin
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doi:10.1093/schbul/9.3.325
更新日期:1983-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbn059
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pub_type: 杂志文章
doi:10.1093/schbul/10.3.371
更新日期:1984-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/10.1.71
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbn110
更新日期:2010-05-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbz060
更新日期:2020-02-26 00:00:00
abstract:INTRODUCTION:Separable, but positively correlated, factors emerge from analyses of cognitive test data in schizophrenia and control samples (eg, verbal memory and processing speed) and these factors guide data reduction. Additionally, data support a hierarchical model of cognitive performance, in which these correlatio...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbq018
更新日期:2011-11-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a007131
更新日期:2004-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbl066
更新日期:2007-09-01 00:00:00
abstract::In contrast with issues of consent capacity, financial capacity has received surprisingly little clinical or ethical attention in the psychiatric literature. Issues of financial capacity emerge frequently regarding clients with serious mental illness (SMI), and their resolution has practical and ethical significance f...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbj027
更新日期:2006-01-01 00:00:00
abstract::The evidence suggesting that genetic factors are involved in the etiology of schizophrenia is reviewed. Despite methodological and other difficulties, independent lines of research--family, twin, and adoption studies--point in a common direction: Persons genetically at risk for schizophrenia are more likely to become ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/6.3.404
更新日期:1980-01-01 00:00:00
abstract::At the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) New Approaches Conference, a discussion group focused on directions for future research that are critical to enhancing our understanding of the distinctions among key cognitive domains that have relevance for the development of c...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbi047
更新日期:2005-10-01 00:00:00
abstract::Instrument-based scores are often used as outcome measures. However, little is known about what changes in scores mean in terms of a clinical assessment of improvement or deterioration. The purpose of this report was to determine how much change in standard instrument scores represents a clinically detectable improvem...
journal_title:Schizophrenia bulletin
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/oxfordjournals.schbul.a006869
更新日期:2001-01-01 00:00:00
abstract::A substantial proportion of patients with schizophrenia experience the onset of their illness by age 18. Data from phenomenological, cognitive, neuroimaging, and genetic studies suggest a similar profile of clinical and neurobiological abnormalities between early- and adult-onset patients. However, children and adoles...
journal_title:Schizophrenia bulletin
pub_type: 社论
doi:10.1093/schbul/sbm123
更新日期:2008-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbn177
更新日期:2009-03-01 00:00:00
abstract::Schizophrenia (SCZ) is associated with differences in subcortical brain volumes and intracranial volume (ICV). However, little is known about the underlying etiology of these brain alterations. Here, we explored whether brain structure volumes and SCZ share genetic risk factors. Using conditional false discovery rate ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbx148
更新日期:2018-06-06 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbu025
更新日期:2014-11-01 00:00:00
abstract::The circadian rest-activity cycle of schizophrenia patients stabilized for more than a year on monotherapy with a "classical" neuroleptic (haloperidol, flupentixol) or with the atypical neuroleptic clozapine was documented by continuous activity monitoring for 3-7 weeks. In this pilot study, the three patients treated...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a006890
更新日期:2001-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/10.2.204
更新日期:1984-01-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbt113
更新日期:2014-07-01 00:00:00
abstract::Sustained attention abnormality in schizophrenia is usually refractory to available treatment. Nicotine can transiently improve sustained attention in schizophrenia patients, although its neural mechanisms are unknown. Understanding the neural basis of this effect may lead to new treatment strategies for this cognitiv...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,随机对照试验
doi:10.1093/schbul/sbp089
更新日期:2011-03-01 00:00:00
abstract::Antistigma campaigns have been promoting a medical view of schizophrenia. Given the growing body of research finding negative associations between biogenetic (BG) causal attributions and stigmatizing attitudes, this approach must be reappraised. The present study investigates the impact of different psychoeducational ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbm131
更新日期:2008-09-01 00:00:00
abstract::Randomized controlled trials for antipsychotic drugs have a variety of design features suited to diverse purposes. Efficacy (or explanatory) trials seek to establish if a drug can reduce psychotic symptoms under ideal circumstances. To isolate drug effects, researchers enroll carefully selected patients. Specialized r...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbm156
更新日期:2008-03-01 00:00:00
abstract::A number of recent articles, many appearing in Schizophrenia Bulletin, signal a renewed interest in phenomenological approaches to our understanding of schizophrenia. These approaches conceptualize schizophrenia as a disorder of altered self-awareness and decreased prereflective social attunement, which may manifest a...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbv035
更新日期:2015-11-01 00:00:00
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journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/14.4.675
更新日期:1988-01-01 00:00:00
abstract::Empirically supported treatments for schizophrenia now include a variety of psychosocial interventions, such as social skills training, vocational rehabilitation, and psychotherapy. As awareness of the functional importance of neurocognitive impairments in schizophrenia has increased, interest in treatments to improve...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.schbul.a007011
更新日期:2003-01-01 00:00:00