Abstract
BackgroundPoor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control. Adherence therapy (AT) is an intervention that seeks to reduce patients’ psychiatric symptoms by enhancing treatment adherence. We aimed to systematically review the trial evidence of the effectiveness of AT on improving clinical outcomes in these patients.MethodSystematic review and meta-analysis of published RCTs. We included studies testing AT as an adjunct intervention against treatment as usual or a comparator intervention in the general adult psychiatric population. The primary outcome of interest was improvement in psychiatric symptoms.ResultsWe included six studies testing AT in schizophrenia spectrum disorders published since 2006. A meta-analysis showed AT significantly reduced psychiatric symptoms compared to usual treatment over a follow-up period of less than 1 year. We found no significant effects of AT on patients’ adherence and adherence attitudes.ConclusionsAT is an effective adjunctive treatment for people with schizophrenia spectrum disorders.ProsperoCRD42015016779Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0801-1) contains supplementary material, which is available to authorized users.
Highlights
Poor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control
Of the three studies reporting adherence behaviours as an outcome, only Chien et al [18] found a significant effect of Adherence therapy (AT) over treatment as usual (TAU)
We suggest that patients with schizophrenia would benefit from receiving AT as an adjunct therapy, especially if they have exhibited positive attitudes or moderate adherence to medication
Summary
Poor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control. Adherence therapy (AT) is an intervention that seeks to reduce patients’ psychiatric symptoms by enhancing treatment adherence. Adherence to antipsychotic treatment is often poor; between 41 and 61 % of patients do not take medication as prescribed [2, 3]. Adherence therapy (AT) is a brief psychological intervention based on the principles of motivational interviewing (MI) and cognitive behavioural therapy (CBT). It was developed by Gray et al [5] building on the work of Kemp et al [6]. Key therapy techniques include medication problem solving, exchanging information, exploring ambivalence, and challenging beliefs. These techniques amplify the personally relevant benefits of treatment, modify illness and treatment beliefs, and resolve ambivalence towards taking medication.
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