A systematic review of factors influencing adherence to antipsychotic medication in schizophrenia-spectrum disorders

Sendt, Kyra-Verena; Tracy, Derek Kenneth; Bhattacharyya, Sagnik

doi:10.1016/j.psychres.2014.11.002

Cited by 245Medication Adherence and ComplianceSchizophrenia research and treatmentMental Health Treatment and Access

A systematic review of factors influencing adherence to antipsychotic medication in schizophrenia-spectrum disorders

Sendt, Kyra-Verena, Tracy, Derek Kenneth, Bhattacharyya, Sagnik·2015·Psychiatry Research

DOI 10.1016/j.psychres.2014.11.002

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Abstract

Adherence to antipsychotics improves outcome in schizophrenia. There is a lack of consensus on which factors most influence adherence behaviour and methodological issues hinder interpretation of existing evidence. A rigorous systematic search designed to identify robustly implicated factors emerging from methodologically rigorous studies narrowed our search to 13 observational studies (total N=6235) relating to adherence, antipsychotics and schizophrenia. Studies varied significantly, with reported adherence rates ranging from 47.2% to 95%. Positive attitude to medication and illness insight were the only factors consistently associated with better adherence, while contradictory results were found for socio-demographic characteristics, symptom severity and side effects. Only distinct aspects of the therapeutic relationship and social support in younger patients were related to good adherence. Antipsychotic type or formulation and neurocognitive functioning did not appear to impact medication adherence. Despite greater methodological rigour in determining studies to include in the present systematic review, it remains difficult to guide clinicians in this vital area and most of the work discussed contained small sample sizes. Future research in this field should therefore prioritise prospective study designs over longer periods and larger samples in naturalistic settings, providing a more appropriate and clinically meaningful framework than widely used cross-sectional designs.

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SDM is an interesting approach to achieve greater knowledge of LAIs and acceptance on behalf of patients and families.
“In such scenario, SDM is certainly an interesting approach to achieve greater knowledge of LAIs and acceptance on behalf of patients and families [35, 36].”
From The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: A clinical review (2020) · cites this paper as [36]
Adoption of SDM appears useful in the long-term treatment of patients with schizophrenia.
“However, the adoption of SDM appears useful in the long-term treatment of patients with schizophrenia where medication non-adherence plays an important role in relapse rates, poor outcome, and high costs [36]”
From The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: A clinical review (2020) · cites this paper as [36]
Medication non-adherence plays an important role in relapse rates, poor outcome, and high costs in schizophrenia.
“However, the adoption of SDM appears useful in the long-term treatment of patients with schizophrenia where medication non-adherence plays an important role in relapse rates, poor outcome, and high costs [36]”
From The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: A clinical review (2020) · cites this paper as [36]

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Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology
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Authors: Sendt, K.-V., Tracy, D. K., & Bhattacharyya, S.
Affiliations: King's College London (GB)
Oxleas NHS Foundation Trust (GB)
Corresponding author: Bhattacharyya, Sagnik
ORCID: Sendt, Kyra-Verena
Tracy, Derek Kenneth
Bhattacharyya, Sagnik
Venue: Psychiatry Research
Publisher: Elsevier BV
Published: 2015-01
Volume: 225
Issue: 1-2
Pages: 14-30
ISSN: 0165-1781 (ISSN-L)
DOI: 10.1016/j.psychres.2014.11.002
OpenAlex: W2068456588
Cited by: 245
References: 156
Citations by year: 2026: 20 · 2025: 21 · 2024: 16 · 2023: 20 · 2022: 16 · 2021: 21 · 2020: 36 · 2019: 27 · 2018: 20 · 2017: 18 · 2016: 19 · 2015: 10
FWCI: 2.00
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Psychiatry Research (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (submittedVersion)
Funders: Medical Research Council, UK (MR/J012149/1)
National Institute of Health Research (NIHR) (NIHR CS-11-001)
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: medication adherence, antipsychotic drugs, schizophrenia spectrum disorders, treatment adherence factors, insight into illness, therapeutic relationship, social support, adverse effects, symptom severity, neurocognitive function
MeSH terms: Adult, Attitude to Health, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Medication Adherence

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A systematic review of factors influencing adherence to antipsychotic medication in schizophrenia-spectrum disorders

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