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Effects of Integrated Treatment on Antipsychotic Medication Adherence in a Randomized Trial in Recent-Onset Schizophrenia

J Clin Psychiatry 2007;68(4):566-571

Objective: Interventions improving adherence to antipsychotic medication are needed. The present study examined the effects on medication adherence of 2 years of integrated treatment for patients with schizophrenia.

Method: Adherence to medication was examined in a randomized controlled trial of 2 years of integrated treatment versus standard treatment. The 50 included patients were consecutively referred to a specialized psychiatric team for treatment of psychosis and were diagnosed with DSM-IV schizophrenia or schizoaffective or schizophreniform disorder. The patients were clinically stable and had less than 2 years' duration of illness. Integrated treatment consisted of assertive outreach community treatment, family psychoeducation and involvement, and social skills training. Good adherence was defined as less than 1 month without medication. Outcomes were compared over 12-month and 24-month follow-up periods. The study was conducted from February 1992 to October 1999.

Results: No difference in adherence between the integrated treatment group and the standard treatment group (chi2 = 0.06, NS) was found. Men were more nonadherent than women (OR 6.11 [CI 1.25 to 29.74], p = .025). Patients living in families with low expressed emotion were less adherent than patients living in families with high expressed emotion (OR 6.04 [CI 1.07 to 34.13], p = .042).

Conclusion: No effects of integrated treatment on medication adherence were found.

Clinical Trials Registration: ClinicalTrials.gov identifier NCT00184509​