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Treatment adherence in schizophrenia: A patient-level meta-analysis of combined CATIE and EUFEST studies
Open accessAbstract
The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients׳ data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p=0.0003), higher levels of hostility (p=0.0002), and impaired insight (p<0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients׳ insight and comorbid substance use and the establishment of therapeutic alliance.
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“Examining the relationship of insight and adherence over time, Zhou et al 31 found that poor insight was predictive of medication discontinuation at one-year follow-up.”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [32]
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Metadata
- Authors
- Czobor, P., Van Dorn, R. A., Citrome, L., Kahn, R. S., Fleischhacker, W. W., & Volavka, J.
- Affiliations
- Semmelweis University (HU)
- New York Medical College (US)
- Innsbruck Medical University (AT)
- New York University (US)
- Corresponding author
- Czobor, Pál
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 25
- Issue
- 8
- Pages
- 1158-1166
- ISSN
- 0924-977X (ISSN-L)
- PMC
- PMC4860611
- OpenAlex
- W2125320544
- Cited by
- 112
- References
- 49
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 2 · 2023: 10 · 2022: 6 · 2021: 16 · 2020: 16 · 2019: 11 · 2018: 13 · 2017: 8 · 2016: 11 · 2015: 3
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Semmelweis University Repository (Semmelweis University) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- National Institute of Mental Health (R01MH093426)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- medication adherence, schizophrenia, antipsychotic drugs, substance use, hostility, insight, akathisia, parkinsonism, dyskinesia, drug discontinuation, therapeutic relationship, predictors of adherence
- MeSH terms
- Assessment of Medication Adherence, Humans, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Randomized Controlled Trials as Topic, Drug Monitoring, Medication Adherence
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