Effects of Adherence to Pharmacological Treatment on the Recovery of Patients with Schizophrenia

The aim of this study was to evaluate the effects of adherence to antipsychotic treatment on the recovery of patients with schizophrenia in northern Chile. One hundred and fifty-one patients diagnosed with schizophrenia completed the Drug Attitude Inventory (DAI-10), Positive and Negative Syndrome Scale for Schizophrenia (PANSS), Recovery Assessment Scale (RAS-24), sociodemographic information, and clinical and treatment characteristics of patients with schizophrenia. Multivariate analysis with multiple linear regression was then performed to identify variables that were potentially associated with the recovery assessment (variable criterion). A significant association was found between adherence to antipsychotic medication and the Willing to Ask for Help dimension of Recovery (β = 0.239, p = 0.005). Association of clinical and socio-demographic variables with recovery were identified: negative symptoms with Personal Confidence and Hope (β = −0.341, p = 0.001) and Goal and Success Orientation (β = −0.266, p = 0.014); cognitive symptoms with Willing to Ask for Help (β = −0.305, p = 0.018) and no domination by symptoms (β = −0.351, p = 0.005); marital status with reliance on others (β = −0.181, p = 0.045); age with Personal Confidence and Hope (β = −0.217, p = 0.021), Goal and Success Orientation (β = −0.296, p = 0.003), and no domination by symptoms (β = 0.214, p = 0.025). Adherence has a positive relationship with personal recovery in this sample of Chilean patients with schizophrenia.

What Do Real Alcohol Outpatients Expect about Alcohol Transdermal Sensors?

Objective: Little is known about the potential acceptability of alcohol transdermal sensors among alcohol-dependent outpatients in routine clinical settings. The aim of the present study was to investigate patients’ attitudes towards alcohol transdermal sensors, as well as features associated with enhanced acceptability and usability. Methods: A cross-sectional survey among routine alcohol outpatients was conducted. The Drug Attitude Inventory (DAI-10) was adapted to the field of alcohol transdermal sensors for attitudes assessment. Likert-type and multiple-choice questions were used for acceptability and usability evaluation. Results: 68 patients completed the questionnaire, and the DAI-10 mean score was 3 (standard deviation (SD) = 6.5). Internal consistency revealed a Cronbach alpha of 0.613. The score of a single The score of a single Likert-type question about overall perceived value was 7.4 (SD = 2.6). Its correlation with mean DAI-10 scores was r = 0.633, with p < 0.001. Relapse prevention and a stricter treatment control from therapists were the main reported advantages. Perceived stigma was the main disadvantage. Features increasing device discretion would enhance its acceptability. Conclusions: The data suggest that transdermal sensors could play a role in the clinical treatment of alcohol outpatients and concerns regarding stigma should be taken into account. Future designs should try to minimize size and visibility and stigma concerns should be discussed with patients.

Predicting Factors Affecting Glucose Monitoring Treatment Satisfaction and Drug Attitude Inventory (Adherence) Among Patients with Type 2 Diabetes Mellitus; Cross-sectional Observational Study

<P>Objectives: The study aimed to explore the predictors affecting patient satisfaction to glucose monitoring system (GMSS) and drug attitude inventory (DAI) / treatment adherence among type 2 diabetes mellitus patients. Methods: Cross-sectional observational study design was used to conduct this study. Subjective assessments were made by questionnaires and objective data was collected from the patients' medication profiles registered to diabetic clinics. Patients were recruited from five different public hospitals of Hyderabad region, India. A total of 430 patients completed for analysis. The predictors to GMSS dimensions and adherence status were analyzed with Wilks's lambda effect and multivariate generalized linear model (GLM/MANOVA). Results: Study population consisted of 64.4% males and 35.6% females, age mean ± SD (43.3±11.42) years, majority of the study of participants were in between 40-60 years of age (53.3%). Majority of participants were considered healthy on BMI scale (67.2%), in contrast 234 (54.4%) reported high glycemic index with Hb1Ac (> 7.5%). Descriptive distribution pattern showed 241 (56.1%) participants were moderately satisfied with the current monitoring system. However, 157 (36.5%) reported poor satisfaction to GMSS scale score. Findings showed that low mean score of openness and worthwhileness are reported among nonadherent participants. Behavioral burden significantly high among nonadherent patients then adherents. However, emotional burden showed no effect on treatment adherence. Conclusion: This study found high rates of poor glucose monitoring system satisfaction along with low-to-poor treatment adherence among T2DM patients. Individual characteristics and clinical parameters significantly and positively predict the variance of GMSS and DAI among patients' with T2DM.</P>

Treatment attitude and hospitalization: Comparison of oral therapy and long-acting injectable (LAI) antipsychotics in patients with schizophrenia

BackgroundAdherence to prescribed antipsychotic drugs is a crucial factor in predicting medium- to long-term clinical outcome in schizophrenia. A helpful approach to promote adherence in schizophrenia is the use of long-acting injectable (LAI) antipsychotics.ObjectTo evaluate:– the global functioning and the hospitalization rate occurred in the year before and in the year following the switch from a low-efficacy oral antipsychotic to either a LAI once-monthly therapy (palmitate paliperidone or olanzapine pamoate) or the corresponding oral compound (paliperidone\risperidone or olanzapine) in schizophrenic patients;– the treatment attitude and the insight in patients treated with second-generation antipsychotic (SGA)-LAIs and with the corresponding oral compounds.MethodSixty adult schizophrenic outpatients: thirty were switched to LAIs and thirty to the corresponding oral antipsychotic. We used the following scales: Drug Attitude Inventory (DAI), Schedule for the Assessment of Insight (SAI), Life Skill Profile (LSP).ResultsNumber of hospitalizations per year decreased in both groups (LAIs: from 1.3 ± 0.5 to 0.3 ± 0.5; oral: from 1.3 ± 0.5 to 0.6 ± 0.5). We found a direct association between the “hospitalization event” and the oral drug compared to the corresponding LAI formulation (P = 0.049; OR: 3.05; 95% IC: 1.01–9.26). Patient receiving LAIs achieved a more significant improvement at the LSP score compared to the oral group (P < 0.001 vs. P = 0.0034) and higher DAI (5.9 ± 4.3 vs. −1.1 ± 4.3) and SAI (8.7 ± 2.9 vs. 5.6 ± 2.1).ConclusionsOur data suggest that SGA-LAIs, improving the adherence to the treatment, may sensitively reduce costs in mental health services.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Therapeutic attitudes and clinical global impression: A 2-year follow-up study of 33 outpatients with a mental disorder in treatment with paliperidone palmitate

IntroductionMaintaining antipsychotic therapy in mental disorder is important in preventing relapse, rehospitalization, and suicide. Lack of awareness of illness may be a leading cause for non-adherence. Long-acting depot can prevent non- adherence and thus potentially contribute to better patient outcomes.ObjectiveThe aim of this prospective, observational, non interventional 2-year-long study is to assess severity and post-intervention changes and attitudes toward medication of a group of patients treated paliperidone palmitate (PP).MethodsThirty-three outpatients stabilised with PP during the last 24 months. Inclusion criteria were: patients’ age (> 18 years), a diagnosis of schizophrenia, bipolar disorder, schizoaffective disorder stabilised during the last 12 months with PP, without a diagnostics from axis I or II (except for nicotine of caffeine) and able to sign the inform consent. Data collected: general sociodemographic and clinical data (age, sex, level of education, socioeconomic situation, family support, psychiatric diagnosis, years of evolution, use/abuse of substances, treatment, previous and later number of hospitalisations. Evaluations included disease severity (Clinical Global Impression-Severity (CGI-S) and Drug Attitude Inventory, (DAI)).ResultsThirty-threeoutpatients were followed during 24 months [mean dose 132,58 (44,4) mg], 75,8% were men, age 45,05 years old, 87,8% with a diagnoses of paranoid schizophrenia. Antipsychotic monotherapy increased over the time with PP. Significant improvements were observed on both Clinical Global Impression and Drug Attitude Inventory. The number of rehospitalizations and mean stays decreased from the beginning until the end of these 24 months.ConclusionsOur results suggest an improvement in the patient's clinical vision and attitude towards medication with long-acting depot.Disclosure of interestThe authors have not supplied their declaration of competing interest.