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Treatment adherence

What is treatment adherence? 

Treatment adherence involves taking prescribed treatments (both pharmaceutical and psychosocial) as recommended by the treating physician.

What is the evidence for treatment adherence?

Moderate quality evidence suggests rates of treatment non-adherence in people with schizophrenia range from 23% to 49%, and the overall dropout rate from psychosocial treatments is around 13%. Treatment adherence is associated with lower medication dosage, positive attitudes towards medication, better clinical and service utilisation outcomes, and may also be associated with better economic outcomes, with the cost of re-hospitalisation due to non-adherence estimated to be between US$1392 million and US$1826 per year.

Factors associated with non-adherence include poor insight, increased psychopathology, negative attitude towards medication, previous treatment non-adherence, poor alliance with clinicians, low outpatient contact, inadequate discharge planning, being young, being male, having low social functioning, having a history of substance abuse, having affective symptoms (depression or anxiety), long hospital stays, being married, and having cognitive impairment. Factors associated with better treatment adherence include having previous psychiatric contacts, family support, good social functioning, living alone/being single, high education, good therapeutic alliance, and facilities for follow up appointments.

Moderate quality evidence suggests subjective methods including patient self-report, clinical provider report, significant other report, and chart review are more commonly used in studies as measures of treatment adherence than objective measures such as pill count, blood or urine analysis, electronic monitoring, and electronic refill records.

Also see the treatment topics for treatment non-adherence (pharmaceutical and psychosocial).

April 2016

Page last updated: 1:55  7 September 2017

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