Non-compliance with typical neuroleptic drugs is well established as a major factor in relapse and re-hospitalization of persons with schizophrenia. Non-compliance has typically been attributed to significant extrapyramidal side effects and lack of efficacy. Atypical antipsychotic drugs are expected to have some impact on non-compliance because of generally lower extrapyramidal side effects and better efficacy. Non-compliance with typical antipsychotics is well established, but no information is available on non-compliance with atypicals. While atypical antipsychotic agents are expected to have an impact on compliance, there will likely remain a need for additional compliance-inducing strategies, as depot administrations and attempts to change attitudes toward medications have not proven effective in the long-term. The purpose of this exploratory study is to collect data on compliance with new antipsychotic medications and to test the effectiveness of telephone medication management (TMM) on compliance with a population of persons with schizophrenia and schizoaffective disorders.
The specific aims of this study are: 1) Examine whether compliance with atypical antipsychotic drugs will be better than that with typical neuroleptics; 2) Evaluate the hypothesis that patients in the TMM program will experience superior quality of life, enhanced functioning, and decreased symptoms; 3) Study whether patients in the TMM program will adhere more closely to medication regimens; and 4) Examine the impact of TMM on hospitalization rates. This exploratory study will utilize a randomized 2X2 design involving 96 persons diagnosed with schizophrenia. Research participants will be non-randomized to medication and randomized to the TMM condition or """"""""treatment as usual."""""""" Those assigned to the TMM condition will initially meet with a TMM staffperson and discuss medication attitudes, develop strageies for taking medications on a consistent basis, and provide psychoeducation about medication side effects. The TMM staffperson will then follow this up with weekly telephone contacts in which they will inquire about compliance and conduct a brief clinical interview. The TMM staffperson will initiate appropriate interventions (i.e., schedule an appointment with the persons physician) to combat relapse and emerging side effects.
| Salzer, Mark S; Tunner, Timothy; Charney, Natalie J (2004) A low-cost, telephone intervention to enhance schizophrenia treatment: a demonstration study. Schizophr Res 66:75-6 |
