Using a pharmacy-based intervention to improve antipsychotic adherence among patients with serious mental illness.

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 Bull

journal_title

Schizophrenia bulletin

authors

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 FC

doi

10.1093/schbul/sbp121

subject

Has Abstract

pub_date

2011-07-01 00:00:00

pages

727-36

issue

4

eissn

0586-7614

issn

1745-1701

pii

sbp121

journal_volume

37

pub_type

杂志文章,多中心研究,随机对照试验
  • Dopamine and Glutamate in Antipsychotic-Responsive Compared With Antipsychotic-Nonresponsive Psychosis: A Multicenter Positron Emission Tomography and Magnetic Resonance Spectroscopy Study (STRATA).

    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

    pub_type: 杂志文章

    doi:10.1093/schbul/sbaa128

    authors: Egerton A,Murphy A,Donocik J,Anton A,Barker GJ,Collier T,Deakin B,Drake R,Eliasson E,Emsley R,Gregory CJ,Griffiths K,Kapur S,Kassoumeri L,Knight L,Lambe EJB,Lawrie SM,Lees J,Lewis S,Lythgoe DJ,Matthews J,McGuire

    更新日期:2020-09-10 00:00:00

  • The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements.

    abstract::In light of the large number of studies published since the 2004 update of Schizophrenia Patient Outcomes Research Team psychopharmacological treatment recommendations, we conducted an extensive literature review to determine whether the current psychopharmacological treatment recommendations required revision and whe...

    journal_title:Schizophrenia bulletin

    pub_type: 共识发展会议,杂志文章,实务指引,评审

    doi:10.1093/schbul/sbp116

    authors: Buchanan RW,Kreyenbuhl J,Kelly DL,Noel JM,Boggs DL,Fischer BA,Himelhoch S,Fang B,Peterson E,Aquino PR,Keller W,Schizophrenia Patient Outcomes Research Team (PORT).

    更新日期:2010-01-01 00:00:00

  • Differences in age of first hospitalization for schizophrenia among immigrants and nonimmigrants in a national case registry.

    abstract::While previous studies have found an increased incidence of schizophrenia in some immigrant groups, differences in age of onset in these groups has not been examined. The purpose of this study was to compare age of first hospitalization of (1) native-born people versus immigrants, (2) immigrants from different countri...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.schbul.a006956

    authors: Rabinowitz J,Fennig S

    更新日期:2002-01-01 00:00:00

  • Variability and the dopamine hypothesis of schizophrenia.

    abstract::The dopamine hypothesis of schizophrenia is usually presented in a static, rather than dynamic fashion. We propose that increased dopaminergic activity may represent a stage of a dynamic schizophrenic process rather than its cause. Dopamine, as well as other neurotransmitters, responds in an adaptive fashion to stimul...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/9.3.325

    authors: Csernansky JG,Holman CA,Hollister LE

    更新日期:1983-01-01 00:00:00

  • Region-specific changes in gamma and beta2 rhythms in NMDA receptor dysfunction models of schizophrenia.

    abstract::Cognitive disruption in schizophrenia is associated with altered patterns of spatiotemporal interaction associated with multiple electroencephalogram (EEG) frequency bands in cortex. In particular, changes in the generation of gamma (30-80 Hz) and beta2 (20-29 Hz) rhythms correlate with observed deficits in communicat...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章,评审

    doi:10.1093/schbul/sbn059

    authors: Roopun AK,Cunningham MO,Racca C,Alter K,Traub RD,Whittington MA

    更新日期:2008-09-01 00:00:00

  • Negative and positive symptoms in schizophrenia and depression: a followup.

    abstract::Negative and positive symptoms were investigated in a sample of 72 young schizophrenic and depressed patients at followup approximately 1 1/2 years after hospital discharge. Flat affect, poverty of speech, and psychomotor retardation were included as negative symptoms, and delusions, hallucinations, and florid thought...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/10.3.371

    authors: Pogue-Geile MF,Harrow M

    更新日期:1984-01-01 00:00:00

  • Vulnerability and schizoaffective psychosis: a two-factor model.

    abstract::Remitting illness such as affective or schizoaffective disorder is appropriately described by a vulnerability model. Clinical evidence is reviewed here to clarify the relationship between the affective-disorder-like and schizophrenia-like symptoms in a schizoaffective episode. A model is proposed which treats vulnerab...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/10.1.71

    authors: Braden W

    更新日期:1984-01-01 00:00:00

  • What is causing the reduced drug-placebo difference in recent schizophrenia clinical trials and what can be done about it?

    abstract::On September 18, 2007, a collaborative session between the International Society for CNS Clinical Trials and Methodology and the International Society for CNS Drug Development was held in Brussels, Belgium. Both groups, with membership from industry, academia, and governmental and nongovernmental agencies, have been f...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/sbn110

    authors: Kemp AS,Schooler NR,Kalali AH,Alphs L,Anand R,Awad G,Davidson M,Dubé S,Ereshefsky L,Gharabawi G,Leon AC,Lepine JP,Potkin SG,Vermeulen A

    更新日期:2010-05-01 00:00:00

  • Synapse Pathology in Schizophrenia: A Meta-analysis of Postsynaptic Elements in Postmortem Brain Studies.

    abstract::Changed synapse density has been suggested to be involved in the altered brain connectivity underlying schizophrenia (SCZ) pathology. However, postmortem studies addressing this topic are heterogeneous and it is not known whether changes are restricted to specific brain regions. Using meta-analysis, we systematically ...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/sbz060

    authors: Berdenis van Berlekom A,Muflihah CH,Snijders GJLJ,MacGillavry HD,Middeldorp J,Hol EM,Kahn RS,de Witte LD

    更新日期:2020-02-26 00:00:00

  • Cognitive factor structure and invariance in people with schizophrenia, their unaffected siblings, and controls.

    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

    authors: Dickinson D,Goldberg TE,Gold JM,Elvevåg B,Weinberger DR

    更新日期:2011-11-01 00:00:00

  • Elevated levels of schizotypal features in parents of patients with a family history of schizophrenia spectrum disorders.

    abstract::There is some evidence that schizotypal traits are related to a genetic or familial liability to develop schizophrenia. However, it is unclear whether the number of schizotypal traits is elevated in parents of schizophrenia patients compared with controls. This study used the Schizotypal Personality Questionnaire to i...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.schbul.a007131

    authors: Appels MC,Sitskoorn MM,Vollema MG,Kahn RS

    更新日期:2004-01-01 00:00:00

  • Neuropsychology of the deficit syndrome: new data and meta-analysis of findings to date.

    abstract::The deficit syndrome is thought to characterize a pathophysiologically distinct subgroup of patients with schizophrenia. Supporting this notion, prior research examining the neuropsychological correlates of the deficit syndrome has suggested the presence of a differential impairment in frontal and parietal functions. ...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章,meta分析,评审

    doi:10.1093/schbul/sbl066

    authors: Cohen AS,Saperstein AM,Gold JM,Kirkpatrick B,Carpenter WT Jr,Buchanan RW

    更新日期:2007-09-01 00:00:00

  • Financial capacity in persons with schizophrenia and serious mental illness: clinical and research ethics aspects.

    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

    authors: Marson DC,Savage R,Phillips J

    更新日期:2006-01-01 00:00:00

  • The genetics of schizophrenia: a review.

    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

    authors: Kessler S

    更新日期:1980-01-01 00:00:00

  • Distinguishing separable domains of cognition in human and animal studies: what separations are optimal for targeting interventions? A summary of recommendations from breakout group 2 at the measurement and treatment research to improve cognition in schiz

    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

    authors: Nuechterlein KH,Robbins TW,Einat H

    更新日期:2005-10-01 00:00:00

  • Detecting improvement in quality of life and symptomatology in schizophrenia.

    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

    authors: Cramer J,Rosenheck R,Xu W,Henderson W,Thomas J,Charney D,Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia.

    更新日期:2001-01-01 00:00:00

  • Editorial: research progress in early-onset schizophrenia.

    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

    authors: Kumra S,Charles Schulz S

    更新日期:2008-01-01 00:00:00

  • Psychosocial treatments to promote functional recovery in schizophrenia.

    abstract::A number of psychosocial treatments are available for persons with schizophrenia that include social skills training, cognitive behavioral therapy, cognitive remediation, and social cognition training. These treatments are reviewed and discussed in terms of how they address key components of functional recovery such a...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章,评审

    doi:10.1093/schbul/sbn177

    authors: Kern RS,Glynn SM,Horan WP,Marder SR

    更新日期:2009-03-01 00:00:00

  • Genetic Overlap Between Schizophrenia and Volumes of Hippocampus, Putamen, and Intracranial Volume Indicates Shared Molecular Genetic Mechanisms.

    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

    authors: Smeland OB,Wang Y,Frei O,Li W,Hibar DP,Franke B,Bettella F,Witoelar A,Djurovic S,Chen CH,Thompson PM,Dale AM,Andreassen OA

    更新日期:2018-06-06 00:00:00

  • A stratified model for psychosis prediction in clinical practice.

    abstract:OBJECTIVE:Impaired cognition is an important dimension in psychosis and its at-risk states. Research on the value of impaired cognition for psychosis prediction in at-risk samples, however, mainly relies on study-specific sample means of neurocognitive tests, which unlike widely available general test norms are difficu...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/sbu025

    authors: Michel C,Ruhrmann S,Schimmelmann BG,Klosterkötter J,Schultze-Lutter F

    更新日期:2014-11-01 00:00:00

  • Disturbed circadian rest-activity cycles in schizophrenia patients: an effect of drugs?

    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

    authors: Wirz-Justice A,Haug HJ,Cajochen C

    更新日期:2001-01-01 00:00:00

  • Social cognitive impairments and negative symptoms in schizophrenia: are there subtypes with distinct functional correlates?

    abstract::Social cognitive impairments and negative symptoms are core features of schizophrenia closely associated with impaired community functioning. However, little is known about whether these are independent dimensions of illness and if so, whether individuals with schizophrenia can be meaningfully classified based on thes...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/sbr125

    authors: Bell MD,Corbera S,Johannesen JK,Fiszdon JM,Wexler BE

    更新日期:2013-01-01 00:00:00

  • Psychophysiological dysfunctions in the developmental course of schizophrenic disorders.

    abstract::Psychophysiological anomalies in symptomatic schizophrenic patients, remitted schizophrenic patients, and individuals at heightened risk for a schizophrenic disorder are reviewed with an emphasis on electrodermal anomalies. Two electrodermal anomalies are identified in different subgroups of symptomatic patients: (1) ...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/10.2.204

    authors: Dawson ME,Nuechterlein KH

    更新日期:1984-01-01 00:00:00

  • Mortality in schizophrenia: clinical and serological predictors.

    abstract::Persons with schizophrenia have a reduced life expectancy largely due to death from natural causes. Factors that have been previously associated with excess mortality include cigarette smoking and antipsychotic medication. The role of other environmental factors such as exposure to infectious agents has been the subje...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/sbt113

    authors: Dickerson F,Stallings C,Origoni A,Schroeder J,Khushalani S,Yolken R

    更新日期:2014-07-01 00:00:00

  • Nicotine enhances but does not normalize visual sustained attention and the associated brain network in schizophrenia.

    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

    authors: Hong LE,Schroeder M,Ross TJ,Buchholz B,Salmeron BJ,Wonodi I,Thaker GK,Stein EA

    更新日期:2011-03-01 00:00:00

  • Can antistigma campaigns be improved? A test of the impact of biogenetic vs psychosocial causal explanations on implicit and explicit attitudes to schizophrenia.

    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

    authors: Lincoln TM,Arens E,Berger C,Rief W

    更新日期:2008-09-01 00:00:00

  • Randomized controlled trials for schizophrenia: study designs targeted to distinct goals.

    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

    authors: Stroup TS,Geddes JR

    更新日期:2008-03-01 00:00:00

  • Schizophrenia, Subjectivity, and Mindreading.

    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

    authors: Nour MM,Barrera A

    更新日期:2015-11-01 00:00:00

  • The impact of education about schizophrenia on relatives varying in expressed emotion.

    abstract::The demand for information by relatives and the success of family intervention programs with an initial didactic component has resulted in a proliferation of educational interventions in schizophrenia. The present study assesses the impact of a single educational session on relatives of recent-onset schizophrenic pati...

    journal_title:Schizophrenia bulletin

    pub_type: 杂志文章

    doi:10.1093/schbul/14.4.675

    authors: Cozolino LJ,Goldstein MJ,Nuechterlein KH,West KL,Snyder KS

    更新日期:1988-01-01 00:00:00

  • A review of cognitive training in schizophrenia.

    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

    authors: Twamley EW,Jeste DV,Bellack AS

    更新日期:2003-01-01 00:00:00