An RCT of adherence therapy for people with schizophrenia in Chiang Mai, Thailand

Abstract

The aim of this paper was to evaluate the effectiveness of adherence therapy-a brief intervention based on compliance therapy and motivational interviewing techniques-in a sample of people with schizophrenia in Thailand. Poor adherence is problematic, but knowledge about how to improve medication adherence is limited. Studies focusing on the effects of interventions used to improve adherence have produced inconsistent outcomes and have been mainly conducted in western countries. An exploratory single blind randomized controlled trial was conducted in Chiang Mai, Thailand. Thirty-two patients with schizophrenia were randomly allocated to receive eight weekly sessions of adherence therapy or continue with their treatment as usual. Patients were assessed at baseline and after nine weeks. The primary outcome was overall psychotic symptoms. Secondary outcomes were general functioning, attitude towards and satisfaction with antipsychotic medication and medication side effects. The findings of this study indicated that patients who received adherence therapy significantly improved in overall psychotic symptoms, attitude towards and satisfaction with medication compared with treatment as usual but no significant difference was found in general functioning or side effects compared with treatment as usual. Adherence therapy has a positive impact on patients' psychiatric symptoms, attitude towards and satisfaction with medication. Nurses can effectively deliver adherence therapy following intensive training.