Abstract

Medication non-adherence is a leading cause of poor treatment outcomes among Thai patients with psychiatric disorders and creates challenges for psychiatric nurses. This systematic review synthesized research on intervention effectiveness for antipsychotic medication adherence in Thai schizophrenic populations. Following PRISMA guidelines, searches were completed in seven databases, including PubMed, PsycINFO, CINAHL, Web of Science, Scopus, ThaiJO, and Google Scholar. No restriction dates were used. Screening and extraction of data were performed systematically. Eligible studies consisted of nine quasi-experimental and two randomized control trial studies. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used to assess the studies’ methodological quality. This review revealed that individual counseling combined with cognitive-behavioral therapy (CBT) and motivational interviewing (MI) techniques improved and maintained medication adherence behavior over time. Post-testing after intervention completion and at 3- and 6-month follow-ups showed that treatment group participants were more adherent than control group participants (p < 0.01). These findings suggest that incorporating CBT and MI into clinical practice can enhance medication adherence behavior. Booster session efficacy for reinforcing and sustaining adherence should be investigated. Greater rigor is warranted in future intervention studies based on a quality appraisal of previous studies.

Highlights

  • According to the World Health Organization (WHO), psychiatric disorders represent a leading cause of morbidity and mortality worldwide [1]

  • While there is a clear need to examine the effectiveness of interventions intended to promote medication adherence among the various populations of psychiatric patients, most published studies of such interventions conducted in Thailand were limited to patients with schizophrenia

  • We focused our systematic review on synthesizing and analyzing available evidence regarding the effectiveness of antipsychotic medication adherence interventions for Thai patients with schizophrenia

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Summary

Introduction

According to the World Health Organization (WHO), psychiatric disorders represent a leading cause of morbidity and mortality worldwide [1]. Approximately 970 million individuals suffer from a diagnosed psychiatric disorder [2]. In Thailand, data from the National Epidemiology of Psychiatric Comorbidity Survey indicated that 14.3% of Thai nationals had been diagnosed with a psychiatric disorder [3]. The most commonly diagnosed psychiatric disorders in Thailand include anxiety disorder, major depressive disorder, substance-use disorders, and schizophrenia, respectively [4]. In 2010, the prevalence of schizophrenia in the. Thai population aged 15 to 59 years was approximately 8.8 per 1000 people [5]. Psychiatric disorders are associated with several negative consequences, such as reduced individual well-being, increased family burden, and barriers to employment and financial stability [6,7]. Psychosocial interventions, case management, problem-solving, and motivational interviewing treatments have been identified that improve patients’ symptoms and overall functioning associated with severe

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