How-To Guides
2 guidesHow to Assess Medication Adherence in Psychiatric Outpatients
How should clinicians assess medication adherence in adult psychiatric outpatients taking oral medications?
How to Choose Acceptable Tablet Formulations in Psychiatric Outpatients
How should clinicians use tablet shape, size, and color preferences when choosing oral psychiatric medications for outpatients?
Frequently Asked Questions
9 questions-
No significant association was found between tablet shape, size, or color preferences and medication adherence in this 232-patient psychiatric outpatient study. All preference/dislike analyses were nonsignificant (all P > .05), with c72 values ranging from 1.90 to 4.64 and small effect sizes (Crame9rs V = 0.090.14). The authors concluded that tablet esthetics may influence acceptability, but they did not predict sustained adherence in this sample.
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Patients most often preferred oval/oblong tablets (43.5%), small tablets (41.4%), and white tablets (41.8%). These were the most favored shape, size, and color categories measured on the study questionnaire.
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The most commonly disliked tablet features were large size (53.4%), flat-circular shape (40.5%), and red color (33.6%). The authors noted that these attributes may affect acceptability even though they were not significantly linked to adherence.
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Overall self-reported adherence was 74.1% among the 232 psychiatric outpatients, based on a Medication Adherence Rating Scale (MARS) score of 610. The 95% confidence interval for adherence was 68.1%79.3%.
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Yes. The lowest adherence rate was observed in psychosis at 30.8% (95% CI, 12.7%57.6%), while the highest was in generalized anxiety disorder at 85.0% (95% CI, 64.0%94.8%). However, the study's statistical analysis found that clinical variables, including diagnosis, did not significantly affect adherence overall (P = .081 to P = .760).
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Medication adherence was measured with the 10-item Medication Adherence Rating Scale (MARS). The study defined patients as adherent if their MARS score was 6 or higher.
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This was a cross-sectional observational study of 232 adult psychiatric outpatients who had been taking oral medications for at least 1 month. Because the design was cross-sectional, it can identify associations at one point in time but cannot establish causality. The sample was recruited consecutively over 6 months from a single psychiatric outpatient department.
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The main limitations were that adherence was measured by self-reported MARS rather than objective methods, the study used a cross-sectional design, and the sample came from a single urban center. The authors noted that self-report may overestimate adherence because of recall and social desirability bias, and they cited only moderate concordance between MARS and objective measures (38 = 0.40.6). They also did not adjust for confounders with multivariable models, which limits interpretation.
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This study does not support changing tablet esthetics alone as a reliable way to improve adherence in psychiatric outpatients. Although patients showed clear preferences for small, oval/oblong, white tablets and dislikes for large, flat-circular, and red tablets, none of these attributes was significantly associated with adherence. The authors instead emphasized holistic strategies such as psychoeducation and cognitive-behavioral approaches.