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Treatment non-adherence

What is treatment non-adherence in PTSD?

Non-adherence to treatments reduces the success of the treatment regimen and the ability to achieve remission from illness. Greater adherence to treatments can contribute to more successful management of the symptoms of PTSD and subsequent better quality of life. It also improves attitudes towards treatment, as well as increasing insight and confidence.

What is the evidence for treatment non-adherence in people with PTSD?

Moderate to high quality evidence found a dropout rate of around 18-21% from psychological treatments for PTSD. Rates were highest in longer studies with more sessions, and in group treatments rather than individual treatments. Cognitive behavioural therapy had significantly more dropouts than applied relaxation, cognitive therapy, integrative approaches, and supportive psychotherapy. Exposure therapy had significantly more dropouts than supportive psychotherapy. Cognitive processing and eye movement desensitisation and reprocessing showed similar rates to the overall rate.

There was a small effect of more medication non-adherence for physical conditions (HIV, myocardial infarction, organ transplant, stroke, cardiovascular disease, and hypertension) in people with PTSD compared to people without PTSD. Non-adherence rates were higher in people whose PTSD was induced by a medical event than by other events. Non-adherence rates were higher in people with vascular disease, and lower in people with HIV, than other conditions.

August 2021

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Last updated at: 3:17 am, 11th October 2021
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