Medication non adherence is the strongest predictor of symptom relapse in persons with schizophrenia spectrum disorders (SSDs = schizophrenia and schizoaffective disorder), accounting for most of the nearly $80 billion annual cost of treating these illnesses in the United States. A large body of research shows that problem-solving interventions are among the most effective treatments for improving adherence and reducing treatment costs, but these interventions are seldom offered due to budget and personnel constraints. In a series of studies we have piloted Telephone Intervention - Problem Solving (TIPS) and found this provider initiated, telephone based intervention protocol to be a feasible, time-efficient way to provide problem solving interventions. TIPS significantly improved medication adherence compared to usual care over 3 months, but one third of eligible persons were excluded from our pilot studies because they lacked or lost home telephone access. In this follow up study based upon Ajzen's Theory of Planned Behavior, we will test the effect of cellular telephone delivered TIPS compared to treatment as usual (TAU) on medication adherence, medication attitudes and symptom management over 9 months. Hypotheses: Persons receiving TIPS will have: 1-higher blood medication levels and higher pill count adherence 2-higher medication attitudes and higher medication adherence self efficacy 3-lower psychiatric symptom scores than controls throughout the 9- month study

Public Health Relevance

Up to three-fourths of persons with schizophrenia spectrum disorders (SSDs) do not fully adhere to prescribed medications, causing costly relapses. Problem solving interventions have been shown to improve adherence but are seldom used in this group due to cost and personnel constraints. Our prior work showed that telephone problem solving significantly improved medication adherence. This follow up study will provide problem solving via cellular telephone, greatly increasing access to this proven treatment.

National Institute of Health (NIH)
Exploratory/Developmental Grants (R21)
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Health Care Technology and Decision Science (HTDS)
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White, Jon
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University of Tennessee Knoxville
Schools of Nursing
United States
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