TY - JOUR
T1 - Attitudes toward medications and the relationship to outcomes in patients with schizophrenia
AU - Campbell, Angela H.
AU - Scalo, Julieta F.
AU - Crismon, M. Lynn
AU - Barner, Jamie C.
AU - Argo, Tami R.
AU - Lawson, Kenneth A.
AU - Miller, Alexander
N1 - Funding Information:
Angela Campbell, Julieta Scalo, Jamie Barner, Tami Argo, and Kenneth Lawson report no conflicts of interest related to this manuscript. Alexander Miller has served on two Data Monitoring Committees for studies sponsored by Otsuka Pharmaceutical Group within the past three years. Lynn Crismon has no disclosures to report that are related to this manuscript; however, Lynn Crismon and Alexander Miller were part of the original TMAP research group and TMAP received support from the following sources: National Institute of Mental Health Grant MH-53799, the Robert Wood Johnson Foundation, the Meadows Foundation, the Lightner-Sams Foundation, the Nanny Hogan Boyd Charitable Trust, the Texas Department of Mental Health and Mental Retardation, the Center for Mental Health Services, the Department of Veterans Affairs, a Health Services Research and Development Research Career Scientist Award (RCS92-403), the Betty Jo Hay Distinguished Chair in Mental Health and the Rosewood Corporation Chair in Biomedical Science, the United States Pharmacopeial Convention, Mental Health Connections (a partnership of Dallas County and Texas State mental health authorities with the Department of Psychiatry of the University of Texas Southwestern Medical Center, funded by the Texas State Legislature and the Dallas County Hospital District), The University of Texas at Austin College of Pharmacy, and the Southwestern Drug Corporation Centennial Fellowship in Pharmacy. The following pharmaceutical companies provided unrestricted educational grants: Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Company, Forest Laborato- ries, GlaxoSmithKline, Janssen Pharmaceutica, Novartis, Organon, Pfizer, and WyethAyerst Laboratories. The authors alone are responsible for the content of this manuscript.
Publisher Copyright:
© 2018 Portland Press Ltd. All rights reserved.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - The determinants of attitudes toward medication (ATM) are not well elucidated. In particular, literature remains equivocal regarding the influence of cognition, adverse events, and psychiatric symptomatology. This study evaluated relationships between those outcomes in schizophrenia and ATM. This is a retrospective analysis of data collected during the Texas Medication Algorithm Project (TMAP, n=307 with schizophrenia-related diagnoses), in outpatient clinics at baseline and every 3 months for =1 year (for cognition: 3rd and 9th month only). The Drug Attitude Inventory (DAI-30) measured ATM, and independent variables were: cognition (Trail Making Test [TMT], Verbal Fluency Test, Hopkins Verbal Learning Test), adverse events (Systematic Assessment for Treatment-Emergent Adverse Events, Barnes Akathisia Rating Scale), psychiatric symptomatology (Brief Psychiatric Rating Scale, Scale for Assessment of Negative Symptoms [SANS]), and medication adherence (Medication Compliance Scale). Analyses included binary logistic regression (cognition, psychiatric symptoms) and chi-square (adverse events, adherence) for baseline comparisons, and linear regression (cognition) or ANOVA (adverse events, adherence) for changes over time. Mean DAI-30 scores did not change over 12 months. Odds of positive ATM increased with higher TMT Part B scores (p=0.03) and lower SANS scores (p=0.02). Worsening of general psychopathology (p<0.001), positive symptoms (p<0.001), and negative symptoms (p=0.007) correlated with negative changes in DAI-30 scores. Relationships between cognition, negative symptoms, and ATM warrant further investigation. Studies evaluating therapies for cognitive deficits and negative symptoms should consider including ATM measures as endpoints. Patterns and inconsistencies in findings across studies raise questions about whether some factors thought to influence ATM have nonlinear relationships.
AB - The determinants of attitudes toward medication (ATM) are not well elucidated. In particular, literature remains equivocal regarding the influence of cognition, adverse events, and psychiatric symptomatology. This study evaluated relationships between those outcomes in schizophrenia and ATM. This is a retrospective analysis of data collected during the Texas Medication Algorithm Project (TMAP, n=307 with schizophrenia-related diagnoses), in outpatient clinics at baseline and every 3 months for =1 year (for cognition: 3rd and 9th month only). The Drug Attitude Inventory (DAI-30) measured ATM, and independent variables were: cognition (Trail Making Test [TMT], Verbal Fluency Test, Hopkins Verbal Learning Test), adverse events (Systematic Assessment for Treatment-Emergent Adverse Events, Barnes Akathisia Rating Scale), psychiatric symptomatology (Brief Psychiatric Rating Scale, Scale for Assessment of Negative Symptoms [SANS]), and medication adherence (Medication Compliance Scale). Analyses included binary logistic regression (cognition, psychiatric symptoms) and chi-square (adverse events, adherence) for baseline comparisons, and linear regression (cognition) or ANOVA (adverse events, adherence) for changes over time. Mean DAI-30 scores did not change over 12 months. Odds of positive ATM increased with higher TMT Part B scores (p=0.03) and lower SANS scores (p=0.02). Worsening of general psychopathology (p<0.001), positive symptoms (p<0.001), and negative symptoms (p=0.007) correlated with negative changes in DAI-30 scores. Relationships between cognition, negative symptoms, and ATM warrant further investigation. Studies evaluating therapies for cognitive deficits and negative symptoms should consider including ATM measures as endpoints. Patterns and inconsistencies in findings across studies raise questions about whether some factors thought to influence ATM have nonlinear relationships.
KW - Antipsychotic
KW - Drug attitude inventory
KW - Outcomes
KW - Schizoaffective disorder
KW - Schizophrenia
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U2 - 10.3371/CSRP.CASC.070415
DO - 10.3371/CSRP.CASC.070415
M3 - Article
C2 - 26218237
AN - SCOPUS:85049209254
SN - 1935-1232
VL - 12
SP - 12
EP - 22
JO - Clinical Schizophrenia and Related Psychoses
JF - Clinical Schizophrenia and Related Psychoses
IS - 1
ER -