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Partial Compliance and Patient Consequences in Schizophrenia: Our Patients Can Do Better. [CME]

J Clin Psychiatry 2003;64:1308-1315

Objective: The primary objective of this review is to evaluate the strategies used to improve patient compliance with antipsychotic medication in the treatment of schizophrenia.

Data Sources: An electronic literature search of relevant studies using MEDLINE and the Cochrane Library (January 1974-December 2002) was performed using the search terms adherence, antipsychotic, atypical, compliance, conventional, and schizophrenia.

Study Selection: English-language and non-English-language articles, references from bibliographies of reviews, original research articles, and other articles of interest were reviewed.

Data Extraction: Data quality was determined by publication in the peer-reviewed literature and the most important information was identified.

Data Synthesis: Atypical antipsychotics are associated with an improved side-effect profile and reduced risk of relapse compared with the older agents. Additional benefit may be provided by long-acting injectable formulations as they provide the confidence of continuous medication coverage.

Conclusions: Successful treatment of patients with schizophrenia requires acknowledgment that partial compliance will present a major barrier to achieving maximum outcomes. Ideally, all patients suspected of partial compliance should be considered suitable for treatment with a long-acting injectable atypical antipsychotic.