A randomized trial comparing in person and electronic interventions for improving adherence to oral medications in schizophrenia

Dawn Velligan, Jim Mintz, Natalie Maples, Xueying Li, Stephanie Gajewski, Heather Carr, Cynthia Sierra

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Poor adherence to medication leads to symptom exacerbation and interferes with the recovery process for patients with schizophrenia. Following baseline assessment, 142 patients in medication maintenance at a community mental health center were randomized to one of 3 treatments for 9 months: (1) PharmCAT, supports including pill containers, signs, alarms, checklists and the organization of belongings established in weekly home visits from a PharmCAT therapist; (2) Med-eMonitor (MM), an electronic medication monitor that prompts use of medication, cues the taking of medication, warns patients when they are taking the wrong medication or taking it at the wrong time, record complaints, and, through modem hookup, alerts treatment staff of failures to take medication as prescribed; (3) Treatment as Usual (TAU). All patients received the Med-eMonitor device to record medication adherence. The device was programmed for intervention only in the MM group. Data on symptoms, global functioning, and contact with emergency services and police were obtained every 3 months. Repeated measures analyses of variance for mixed models indicated that adherence to medication was significantly better in both active conditions than in TAU (both p<0.0001). Adherence in active treatments ranged from 90-92% compared to 73% in TAU based on electronic monitoring. In-person and electronic interventions significantly improved adherence to medication, but that did not translate to improved clinical outcomes. Implications for treatment and health care costs are discussed.

Original languageEnglish (US)
Pages (from-to)999-1007
Number of pages9
JournalSchizophrenia bulletin
Volume39
Issue number5
DOIs
StatePublished - Sep 2013

Keywords

  • cognitive adaptation
  • electronic adherence intervention
  • environmental supports
  • medication adherence
  • medication compliance
  • pill containers
  • smart
  • training

ASJC Scopus subject areas

  • Psychiatry and Mental health

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