Redefining Medication Adherence in the Treatment of Schizophrenia
Abstract
Medication adherence is as much of a problem today as it was 50 years ago. A major barrier to progress is that the definition emphasizes obedience to medication recommendations rather than shared outcome goals. As a result, schizophrenia patients are keenly aware of the social risks of disclosing nonadherence. Nondisclosure leads to misinformation, which in turn leads to serious errors in medication decisions. Another consequence is that adherence struggles may harm the therapeutic relationship. When nonadherence is inevitable, the strategy should shift to the use of harm reduction strategies that aim to preserve the therapeutic relationship while mitigating risks.
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Disruption of treatment coverage has been associated with symptom relapse and increased risk of hospitalization.
“Disruption of treatment coverage has been associated with symptom relapse and increased risk of hospitalization [5–7].”
From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [5]
Cites
Interventions for enhancing medication adherence
Nieuwlaat, R., Wilczynski, N., Navarro, T., Hobson, N., Jeffery, R., Keepanasseril, A., Agoritsas, T., Mistry, N., Iorio, A., Jack, S., et al. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000011.pub4 · Cited by 2,945 · see citing works
A systematic review of the associations between dose regimens and medication compliance
Claxton, A. J., Cramer, J., & Pierce, C. (2001) · Clinical Therapeutics · doi:10.1016/s0149-2918(01)80109-0 · Cited by 2,388 · see citing works
Medication compliance and persistence: terminology and definitions
Cramer, J. A., Roy, A., Burrell, A., Fairchild, C. J., Fuldeore, M. J., Ollendorf, D. A., & Wong, P. K. (2008) · Value in Health · doi:10.1111/j.1524-4733.2007.00213.x · Cited by 2,220 · see citing works
Determinants of Medication Compliance in Schizophrenia: Empirical and Clinical Findings
Fenton, W. S., Blyler, C. R., & HEINSSEN, R. K. (1997) · Schizophrenia Bulletin · doi:10.1093/schbul/23.4.637 · Cited by 944 · see citing works
The 2009 Schizophrenia PORT Psychopharmacological Treatment Recommendations and Summary Statements
Buchanan, R. W., Kreyenbuhl, J. A., Kelly, D. L., Noel, J. M., Boggs, D. L., Fischer, B. A., Himelhoch, S. S., Fang, B., Peterson, E. L., Aquino, P. R., et al. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp116 · Cited by 901 · see citing works
Weiden, P. J., Kozma, C., Grogg, A., & Locklear, J. (2004) · Psychiatric Services · doi:10.1176/appi.ps.55.8.886 · Cited by 621 · see citing works
Self-citationPredictors of Noncompliance in Patients With Schizophrenia
Perkins, D. O. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n1206 · Cited by 546 · see citing works
Interventions to Improve Medication Adherence in Schizophrenia
Zygmunt, A., Olfson, M., Boyer, C. A., & Mechanic, D. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.10.1653 · Cited by 541 · see citing works
Ascher‐Svanum, H., Faries, D. E., Zhu, B., Ernst, F. R., Swartz, M. S., & Swanson, J. W. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0317 · Cited by 485 · see citing works
Update on Family Psychoeducation for Schizophrenia
Dixon, L. B., Adams, C., & Lucksted, A. A. (2000) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a033446 · Cited by 342 · see citing works
Kane (2003) · The Journal of Clinical Psychiatry · Cited by 324 · see citing works
Defining and Assessing Adherence to Oral Antipsychotics: A Review of the Literature
Velligan, D. I., Lam, Y.-W. F., Glahn, D. C., Barrett, J. A., Maples, N. J., Ereshefsky, L., & Miller, A. L. (2005) · Schizophrenia Bulletin · doi:10.1093/schbul/sbj075 · Cited by 310 · see citing works
Relapse and Rehospitalization During Maintenance Treatment of Schizophrenia
Schooler, N. R. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830170079011 · Cited by 298 · see citing works
Poor Antipsychotic Adherence Among Patients With Schizophrenia: Medication and Patient Factors
Valenstein, M. M., Blow, F. C., Copeland, L. A., McCarthy, J. F., Zeber, J. E., Gillon, L., Bingham, C. R., & Stavenger, T. (2004) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a007076 · Cited by 273 · see citing works
Subotnik, K. L., Casaus, L. R., Ventura, J., Luo, J. S., Hellemann, G. S., Gretchen-Doorly, D., Marder, S., & Nuechterlein, K. H. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2015.0270 · Cited by 262 · see citing works
Relationships Among Subjective and Objective Measures of Adherence to Oral Antipsychotic Medications
Velligan, D. I., Wang, M., Diamond, P. M., Glahn, D. C., Castillo, D., Bendle, S., Lam, Y. W. F., Ereshefsky, L., & Miller, A. L. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.9.1187 · Cited by 250 · see citing works
Antipsychotic Adherence Over Time Among Patients Receiving Treatment for Schizophrenia
Valenstein, M. M., Ganoczy, D. A., McCarthy, J. F., Kim, H. M., Lee, T. A., & Blow, F. C. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n1008 · Cited by 238 · see citing works
Perkins, D. O., Gu, H., Weiden, P. J., McEvoy, J. P., Hamer, R. M., & Lieberman, J. A. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0114 · Cited by 220 · see citing works
Self-citationVelligan, D. I., Weiden, P. J., Sajatovic, M., Scott, J. L., Carpenter, D. P., ROSS, R. W., & Docherty, J. P. (2010) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000388626.98662.a0 · Cited by 180 · see citing works
Self-citationAntipsychotic Medication Adherence in Schizophrenia
Byerly, M., Nakonezny, P. A., & Lescouflair, E. (2007) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2007.04.002 · Cited by 177 · see citing works
Gray, R. J., Wykes, T., & Gournay, K. (2002) · Journal of Psychiatric and Mental Health Nursing · doi:10.1046/j.1365-2850.2002.00474.x · Cited by 166 · see citing works
Measurement of psychiatric treatment adherence
Sajatovic, M., Velligan, D. I., Weiden, P. J., Valenstein, M. M., & Ogedegbe, G. G. (2009) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.05.007 · Cited by 155 · see citing works
Self-citationPsychoeducation and Compliance in the Treatment of Schizophrenia
Pitschel‐Walz, G., Bäuml, J., Bender, W., Engel, R. R., Wagner, M., & Kissling, W. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0316 · Cited by 150 · see citing works
Alphs, L. D., Benson, C. J., Cheshire-Kinney, K., Lindenmayer, J., Mao, L., Rodriguez, S. C., & Starr, H. L. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09584 · Cited by 137 · see citing works
Velligan, D. I., Weiden, P. J., Sajatovic, M., Scott, J., Carpenter, D., Ross, R., & Docherty, J. P. (2010) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000367776.96012.ca · Cited by 134 · see citing works
Self-citationPriebe, S., Yeeles, K., Bremner, S. A., Lauber, C., Eldridge, S. M., Ashby, D., David, A. S., O’Connell, N., Forrest, A., & Burns, T. (2013) · BMJ · doi:10.1136/bmj.f5847 · Cited by 115 · see citing works
Treatment adherence therapy in people with psychotic disorders: randomised controlled trial
Staring, A. B. P., van der Gaag, M., Koopmans, G. T., Selten, J., Beveren, J. M. V., Hengeveld, M. W., LOONEN, A. J. M., & Mulder, C. L. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.110.077289 · Cited by 115 · see citing works
Maintenance Medication for Schizophrenia: Strategies for Dose Reduction
Schooler, N. R. (1991) · Schizophrenia Bulletin · doi:10.1093/schbul/17.2.311 · Cited by 102 · see citing works
Evidence-based pharmacotherapy of schizophrenia
Leucht, S., Heres, S., Kissling, W., & Davis, J. M. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145710001380 · Cited by 102 · see citing works
Weiden, P. J., & Buckley, P. F. (2007) · PubMed · Cited by 92 · see citing works
Self-citationKopelowicz, A. J. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.135 · Cited by 92 · see citing works
Valenstein, M. M., Kavanagh, J., Lee, T. A., Reilly, P., Dalack, G. W., Grabowski, J., Smelson, D. A., Ronis, D. L., Ganoczy, D. A., Woltmann, E. M., et al. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp121 · Cited by 91 · see citing works
The influence of therapeutic alliance and insight on medication adherence in schizophrenia
Misdrahi, D., Petit, M., Blanc, O., Bayle, F., & Llorca, P. (2011) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2011.598556 · Cited by 89 · see citing works
Velligan, D., Mintz, J., Maples, N., Xueying, L., Gajewski, S., Carr, H., & Sierra, C. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbs116 · Cited by 87 · see citing works
A Trial of Compliance Therapy in Outpatients With Schizophrenia or Schizoaffective Disorder
Byerly, M., Fisher, R., Carmody, T. J., & Rush, A. J. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0806 · Cited by 82 · see citing works
McCabe, R., Healey, P. G. T., Priebe, S., Lavelle, M., Dodwell, D., Laugharne, R. A., Snell, A., & Bremner, S. A. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2013.05.015 · Cited by 81 · see citing works
Understanding and addressing adherence issues in schizophrenia: from theory to practice.
Weiden, P. J. (2007) · PubMed · Cited by 77 · see citing works
Self-citationPsychotherapeutic Management Techniques in the Treatment of Outpatients With Schizophrenia
Weiden, P. J., & HAVENS, L. L. (1994) · Psychiatric Services · doi:10.1176/ps.45.6.549 · Cited by 73 · see citing works
Self-citationTranulis, C., GOFF, D. C., Henderson, D. C., & Freudenreich, O. (2011) · Psychiatric Services · doi:10.1176/ps.62.8.pss6208_0888 · Cited by 73 · see citing works
The expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders.
(2003) · PubMed · Cited by 67 · see citing works
Barkhof, E., Meijer, C. J., de Sonneville, L. M. J., LINSZEN, D. H., & de Haan, L. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbt138 · Cited by 64 · see citing works
Weiden, P. J., Preskorn, S., Fahnestock, P. A., Carpenter, D. P., ROSS, R. W., & Docherty, J. P. (2007) · PubMed · Cited by 63 · see citing works
Self-citationSellwood, W., Tarrier, N., QUINN, J., & Barrowclough, C. (2002) · Psychological Medicine · doi:10.1017/s0033291702006888 · Cited by 62 · see citing works
The Challenge of Offering Long-Acting Antipsychotic Therapies
Weiden, P. J., Roma, R. S., Velligan, D. I., Alphs, L. D., DiChiara, M., & Davidson, B. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.13m08946 · Cited by 55 · see citing works
Self-citationMojtabai, R., Lavelle, J., Gibson, P. J., Sohler, N., Craig, T., Carlson, G. A., & Bromet, E. J. (2002) · Psychiatric Services · doi:10.1176/appi.ps.53.3.337 · Cited by 53 · see citing works
Schulz, M., Gray, R. J., Spiekermann, A., Abderhalden, C., Behrens, J., & Drießen, M. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.01.028 · Cited by 50 · see citing works
Nonadherence to antipsychotics: The role of positive attitudes towards positive symptoms
Moritz, S., Hünsche, A., & Lincoln, T. M. (2014) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2014.09.008 · Cited by 45 · see citing works
Use of Environmental Supports Among Patients With Schizophrenia
Velligan, D. I., Mueller, J., Wang, M., DiCocco, M., Diamond, P. M., Maples, N. J., & Davis, B. (2006) · Psychiatric Services · doi:10.1176/appi.ps.57.2.219 · Cited by 45 · see citing works
Understanding and Treating “First-Episode” Schizophrenia
Weiden, P. J., Buckley, P. F., & Grody, M. B. (2007) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2007.04.010 · Cited by 39 · see citing works
Self-citationMethodological Challenges in Psychiatric Treatment Adherence Research
Velligan, D. I., Sajatovic, M., Valenstein, M. M., Riley, W. T., Safren, S. A., Lewis‐Fernández, R., Weiden, P. J., Ogedegbe, G. G., & Jamison, J. (2010) · Clinical Schizophrenia & Related Psychoses · doi:10.3371/csrp.4.1.6 · Cited by 37 · see citing works
Self-citationEfficacy of the Team Solutions Program for Educating Patients About Illness Management and Treatment
Vreeland, B., Minsky, S., Yanos, P. T., Menza, M. A., Gara, M. A., Kim, E., Toto, A. M., & Allen, L. (2006) · Psychiatric Services · doi:10.1176/appi.ps.57.6.822 · Cited by 36 · see citing works
Efficacy of the Team Solutions Program for Educating Patients About Illness Management and Treatment
Vreeland, B., Minsky, S. K., Yanos, P. T., et al. (2006) · Psychiatric Services · doi:10.1176/ps.2006.57.6.822 · Cited by 25 · see citing works
Shea, S. C., & Barney, C. (2015) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2014.10.001 · Cited by 24 · see citing works
Atorvastatin-Induced Diaphragmatic Muscle Impairment
Sulem, P., Bagheri, H., Faixo, Y., & Montastruc, J. L. (2001) · Annals of Pharmacotherapy · doi:10.1345/aph.10366 · Cited by 21 · see citing works
Jaeger, S., Weißhaupt, S., Flammer, E., & Steinert, T. (2014) · American Journal of Health Behavior · doi:10.5993/ajhb.38.6.13 · Cited by 14 · see citing works
Lencer, R., Harris, M. S. H., Weiden, P. J., Stieglitz, R., & Vauth, R. (2011) · Cited by 13 · see citing works
Self-citationAdherence to psychiatric treatments
Riley, W. T., Velligan, D. I., Sajatovic, M., Valenstein, M. M., Safren, S. A., Lewis‐Fernández, R., Weiden, P. J., & Ogedegbe, O. (2009) · Cited by 12 · see citing works
Self-citationLong-Acting Injectable Antipsychotics and the Management of Nonadherence
Weiden, P. J., Solari, H., Kim, S., & Bishop, J. R. (2011) · Psychiatric Annals · doi:10.3928/00485713-20110425-06 · Cited by 10 · see citing works
Self-citationThe Adherence Interview: Better Information, Better Alliance
Weiden, P. J. (2011) · Psychiatric Annals · doi:10.3928/00485713-20110425-07 · Cited by 5 · see citing works
Self-citationThe “Medication Interest Model”
Shea, S. C. (2009) · Professional Case Management · doi:10.1097/01.pcama.0000343141.89259.d7 · Cited by 3 · see citing works
Staring, A. B. P., van der Gaag, M., Koopmans, G. T., Selten, J., van Beveren, N. J. M., LOONEN, A. J. M., & Mulder, N. L. (2011) · University of Groningen research database (University of Groningen / Centre for Information Technology) · Cited by 1 · see citing works
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- Authors
- Weiden, P. J.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Weiden, Peter J.
- ORCID
- Weiden, Peter J.
- Venue
- Psychiatric Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 39
- Issue
- 2
- Pages
- 199-216
- ISSN
- 0193-953X (ISSN-L)
- OpenAlex
- W2293940305
- Cited by
- 16
- References
- 60
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 5 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 1 · 2012: 1
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R34MH080978)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- medication adherence, schizophrenia, non-compliance, non-disclosure, therapeutic relationship, harm reduction, medication decision-making, patient-physician communication
- MeSH terms
- Communication, Humans, Physician-Patient Relations, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Medication Adherence
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