The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia

Alex Kopelowicz, Roberto Zarate, Charles J. Wallace, Robert Paul Liberman, Steven R. Lopez, Jim Mintz

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Original languageEnglish
Pages (from-to)265-273
Number of pages9
JournalArchives of General Psychiatry
Volume69
Issue number3
DOIs
StatePublished - Mar 2012

Fingerprint

Aptitude
Medication Adherence
Schizophrenia
Group Psychotherapy
Hospitalization
Therapeutics
Psychiatry
Community Mental Health Centers
Los Angeles
Mexican Americans
Adherence
Health Services Needs and Demand
Psychotic Disorders
Inpatients
Medication
Randomized Controlled Trials
Outcome Assessment (Health Care)
Interviews

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Arts and Humanities (miscellaneous)

Cite this

The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia. / Kopelowicz, Alex; Zarate, Roberto; Wallace, Charles J.; Liberman, Robert Paul; Lopez, Steven R.; Mintz, Jim.

In: Archives of General Psychiatry, Vol. 69, No. 3, 03.2012, p. 265-273.

Research output: Contribution to journalArticle

Kopelowicz, Alex ; Zarate, Roberto ; Wallace, Charles J. ; Liberman, Robert Paul ; Lopez, Steven R. ; Mintz, Jim. / The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia. In: Archives of General Psychiatry. 2012 ; Vol. 69, No. 3. pp. 265-273.
@article{39955f95c5774ae7846de317a99793bf,
title = "The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia",
abstract = "Context: Evidence-based interventions to improve medication adherence among patients with schizophrenia are lacking. Although family psychoeducation has demonstrated efficacy in improving outcomes in schizophrenia, empirical support for its ability to enhance medication adherence is scarce. Objective: To determine whether a culturally adapted, multifamily group (MFG) therapy would increase medication adherence and decrease psychiatric hospitalizations for Spanish-speaking Mexican Americans with schizophrenia. Design: A total of 174 Mexican American adults with schizophrenia-spectrum disorder and their key relatives were studied in a 3-armed, randomized controlled trial of MFG therapy focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months. Setting: Two community mental health centers in Los Angeles, California. Participants: Patients had a diagnosis of schizophrenia or schizoaffective disorder with a recent exacerbation of psychotic symptoms and nonadherence to medication before enrollment. Intervention: Patients participated in 1 of 2 MFGs (MFG-adherence or MFG-standard) or treatment as usual. Groups convened twice monthly in 90-minute sessions for 1 year. Main Outcome Measures: The Treatment Compliance Interview uses multiple sources of information to quantify medication adherence. Computerized records were used to collect information on the use of inpatient resources. Results: At the end of the 1-year treatment, MFG-adherence was associated with higher medication adherence than MFG-standard or treatment as usual only (F=6.41; P=.003). The MFG-adherence participants had a longer time to first hospitalization (χ 2=13.3; P=.001) and were less likely to be hospitalized than those in MFG-standard (χ 2=8.2; P=.04) and treatment as usual alone (χ 2=11.3; P<.001). Increased adherence accounted for one-third of the overall effect of treatment on the reduced risk for psychiatric hospitalization. Conclusion: Multifamily group therapy specifically tailored to improve medication adherence through a focus on the beliefs and attitudes of the target population is associated with improved outcome for Mexican American adults with schizophrenia-spectrum disorders. Trial Registration: clinicaltrials.gov Identifier: NCT01125267.",
author = "Alex Kopelowicz and Roberto Zarate and Wallace, {Charles J.} and Liberman, {Robert Paul} and Lopez, {Steven R.} and Jim Mintz",
year = "2012",
month = "3",
doi = "10.1001/archgenpsychiatry.2011.135",
language = "English",
volume = "69",
pages = "265--273",
journal = "JAMA Psychiatry",
issn = "2168-622X",
publisher = "American Medical Association",
number = "3",

}

TY - JOUR

T1 - The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia

AU - Kopelowicz, Alex

AU - Zarate, Roberto

AU - Wallace, Charles J.

AU - Liberman, Robert Paul

AU - Lopez, Steven R.

AU - Mintz, Jim

PY - 2012/3

Y1 - 2012/3

N2 - Context: Evidence-based interventions to improve medication adherence among patients with schizophrenia are lacking. Although family psychoeducation has demonstrated efficacy in improving outcomes in schizophrenia, empirical support for its ability to enhance medication adherence is scarce. Objective: To determine whether a culturally adapted, multifamily group (MFG) therapy would increase medication adherence and decrease psychiatric hospitalizations for Spanish-speaking Mexican Americans with schizophrenia. Design: A total of 174 Mexican American adults with schizophrenia-spectrum disorder and their key relatives were studied in a 3-armed, randomized controlled trial of MFG therapy focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months. Setting: Two community mental health centers in Los Angeles, California. Participants: Patients had a diagnosis of schizophrenia or schizoaffective disorder with a recent exacerbation of psychotic symptoms and nonadherence to medication before enrollment. Intervention: Patients participated in 1 of 2 MFGs (MFG-adherence or MFG-standard) or treatment as usual. Groups convened twice monthly in 90-minute sessions for 1 year. Main Outcome Measures: The Treatment Compliance Interview uses multiple sources of information to quantify medication adherence. Computerized records were used to collect information on the use of inpatient resources. Results: At the end of the 1-year treatment, MFG-adherence was associated with higher medication adherence than MFG-standard or treatment as usual only (F=6.41; P=.003). The MFG-adherence participants had a longer time to first hospitalization (χ 2=13.3; P=.001) and were less likely to be hospitalized than those in MFG-standard (χ 2=8.2; P=.04) and treatment as usual alone (χ 2=11.3; P<.001). Increased adherence accounted for one-third of the overall effect of treatment on the reduced risk for psychiatric hospitalization. Conclusion: Multifamily group therapy specifically tailored to improve medication adherence through a focus on the beliefs and attitudes of the target population is associated with improved outcome for Mexican American adults with schizophrenia-spectrum disorders. Trial Registration: clinicaltrials.gov Identifier: NCT01125267.

AB - Context: Evidence-based interventions to improve medication adherence among patients with schizophrenia are lacking. Although family psychoeducation has demonstrated efficacy in improving outcomes in schizophrenia, empirical support for its ability to enhance medication adherence is scarce. Objective: To determine whether a culturally adapted, multifamily group (MFG) therapy would increase medication adherence and decrease psychiatric hospitalizations for Spanish-speaking Mexican Americans with schizophrenia. Design: A total of 174 Mexican American adults with schizophrenia-spectrum disorder and their key relatives were studied in a 3-armed, randomized controlled trial of MFG therapy focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months. Setting: Two community mental health centers in Los Angeles, California. Participants: Patients had a diagnosis of schizophrenia or schizoaffective disorder with a recent exacerbation of psychotic symptoms and nonadherence to medication before enrollment. Intervention: Patients participated in 1 of 2 MFGs (MFG-adherence or MFG-standard) or treatment as usual. Groups convened twice monthly in 90-minute sessions for 1 year. Main Outcome Measures: The Treatment Compliance Interview uses multiple sources of information to quantify medication adherence. Computerized records were used to collect information on the use of inpatient resources. Results: At the end of the 1-year treatment, MFG-adherence was associated with higher medication adherence than MFG-standard or treatment as usual only (F=6.41; P=.003). The MFG-adherence participants had a longer time to first hospitalization (χ 2=13.3; P=.001) and were less likely to be hospitalized than those in MFG-standard (χ 2=8.2; P=.04) and treatment as usual alone (χ 2=11.3; P<.001). Increased adherence accounted for one-third of the overall effect of treatment on the reduced risk for psychiatric hospitalization. Conclusion: Multifamily group therapy specifically tailored to improve medication adherence through a focus on the beliefs and attitudes of the target population is associated with improved outcome for Mexican American adults with schizophrenia-spectrum disorders. Trial Registration: clinicaltrials.gov Identifier: NCT01125267.

UR - http://www.scopus.com/inward/record.url?scp=84857944959&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857944959&partnerID=8YFLogxK

U2 - 10.1001/archgenpsychiatry.2011.135

DO - 10.1001/archgenpsychiatry.2011.135

M3 - Article

C2 - 22393219

AN - SCOPUS:84857944959

VL - 69

SP - 265

EP - 273

JO - JAMA Psychiatry

JF - JAMA Psychiatry

SN - 2168-622X

IS - 3

ER -