Factors associated with complete discontinuation of medication among patients with schizophrenia in the year after hospital discharge
Abstract
Medication discontinuation is a major risk factor for relapse in schizophrenic patients. The present study investigated the rate and clinical correlates of complete medication discontinuation in the year after hospital discharge. Data collected from 236 schizophrenia patients who were prescribed anti-psychotics documented socio-demographic characteristics, symptom severity, insight, and attitudes towards medication in the week before their discharge and the experience of caregiver burden for their primary caregiver as recorded at the time of hospitalization. Follow-up telephones call one-year after discharge documented whether they were regularly taking prescribed psychotropic medication or not. Logistic regression analysis was used to investigate factors that were independently associated with medication discontinuation. Altogether 25.8% of the sample discontinued medication in the one-year after discharge. Logistic regression analysis showed that shorter duration of illness, lack of health insurance, and poor insight at the time of discharge were significantly associated with complete discontinuation of medication (p<0.05). Patients discontinued their medication within a year after psychiatric hospitalization which was associated with a lack of insurance coverage, less insight into their illness and shorter duration of illness. Interventions that strengthen patient engagement in treatment through insurance coverage and insight, fostered through psychoeducational intervention, may increase medication compliance.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Poor insight predicts medication discontinuation and less adherence over time.
“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 [31]
Cites
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., Keefe, R. S. E., Davis, S. M., Davis, C. E., Lebowitz, B. D., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa051688 · Cited by 5,892 · see citing works
Self-citationMedication 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
Lacro, J. P., Dunn, L. B., Dolder, C. R., Leckband, S. G., & Jeste, D. V. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n1007 · Cited by 1,383 · cited 1× · see citing works
“A comprehensive review (Lacro et al., 2002) reported that the rate of medication non-adherence in patients with schizophrenia is as high as 40%–50%.”
BackgroundA systematic review of adherence with medications for diabetes
Cramer, J. A. (2004) · Diabetes Care · doi:10.2337/diacare.27.5.1218 · Cited by 1,203 · see citing works
Hogan, T. P., Awad, A. G., & Eastwood, R. (1983) · Psychological Medicine · doi:10.1017/s0033291700050182 · Cited by 1,027 · see citing works
Velligan, D. I., Weiden, P. J., Sajatovic, M., Scott, J. L., Carpenter, D., Ross, R., & Docherty, J. P. (2009) · PubMed · Cited by 625 · 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
Tiihonen, J., Haukka, J., Taylor, M., Haddad, P. M., Patel, M. X., & Korhonen, P. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10081224 · Cited by 619 · see citing works
Medication adherence of individuals with a first episode of psychosis
Coldham, E. L., Addington, J., & Addington, D. E. (2002) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2002.02437.x · Cited by 415 · see citing works
Antipsychotic Medication Adherence: Is There a Difference Between Typical and Atypical Agents?
Dolder, C. R., Lacro, J. P., Dunn, L. B., & Jeste, D. V. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.1.103 · Cited by 385 · see citing works
Pharmacy Data Identify Poorly Adherent Patients With Schizophrenia at Increased Risk for Admission
Valenstein, M. M., Copeland, L. A., Blow, F. C., McCarthy, J. F., Zeber, J. E., Gillon, L., Bingham, C. R., & Stavenger, T. (2002) · Medical Care · doi:10.1097/00005650-200208000-00002 · Cited by 333 · see citing works
DiBonaventura, M., Gabriel, S., Dupclay, L., Gupta, S., & Kim, E. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-20 · Cited by 333 · cited 1× · see citing works
“Thirdly, medication side effects were not assessed in the present study, which previous research suggests can be an important reason for non-adherence to prescribed mediation regimens (Dibonaventura et al., 2012).”
BackgroundDefining 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
Medication adherence in schizophrenia
Acosta, F. J. (2012) · World Journal of Psychiatry · doi:10.5498/wjp.v2.i5.74 · Cited by 215 · see citing works
Antipsychotic 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
Chinese Lay Theory and Mental Illness Stigma: Implications for Research and Practices
Lam, C. S., Tsang, H. W. H., Corrigan, P. W., Lee, Y., Angell, B., Shi, K., Jin, S., & Larson, J. E. (2010) · PolyU Institutional Research Archive (Hong Kong Polytechnic University) · Cited by 175 · see citing works
Liu‐Seifert, H., Adams, D. H., & Kinon, B. J. (2005) · BMC Medicine · doi:10.1186/1741-7015-3-21 · Cited by 153 · see citing works
Predictors of medication adherence in patients with schizophrenia and bipolar disorder
Jónsdóttir, H., Opjordsmoen, S., Birkenaes, A. B., Simonsen, C., Engh, J. A., Ringen, P. A., Vaskinn, A., Friis, S., Sundet, K. S., & Andreassen, O. A. (2012) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2012.01911.x · Cited by 152 · see citing works
PERLICK, D. A., Rosenheck, R. A., Clarkin, J. F., Maciejewski, P. K., Sirey, J. A., Struening, E. L., & Link, B. G. (2004) · Psychiatric Services · doi:10.1176/appi.ps.55.9.1029 · Cited by 142 · see citing works
Self-citationImpact of Family Burden and Patient Symptom Status on Clinical Outcome in Bipolar Affective Disorder
PERLICK, D. A., Rosenheck, R., Clarkin, J. F., Raue, P. J., & Sirey, J. A. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200101000-00006 · Cited by 120 · see citing works
Self-citationKarow, A., Czekalla, J., Dittmann, R., Schacht, A., Wagner, T., Lambert, M., SCHIMMELMANN, B. G., & Naber, D. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0110 · Cited by 116 · see citing works
Reappraising insight in psychosis
Cuesta, M. J., Peralta, V., & Zarzuela, A. (2000) · The British Journal of Psychiatry · doi:10.1192/bjp.177.3.233 · Cited by 111 · see citing works
Special Section on CATIE Baseline Data: Components and Correlates of Family Burden in Schizophrenia
PERLICK, D. A., Rosenheck, R. A., Kaczynski, R., Swartz, M. S., Cañive, J. M., & Lieberman, J. A. (2006) · Psychiatric Services · doi:10.1176/ps.2006.57.8.1117 · Cited by 111 · see citing works
Self-citationThe CATIE and CUtLASS Studies in Schizophrenia
Naber, D., & Lambert, M. (2009) · CNS Drugs · doi:10.2165/00023210-200923080-00002 · Cited by 105 · see citing works
Phillips, M. R., Xiong, W., Wang, R. W., Gao, Y. H., Wang, X. Q., & Zhang, N. P. (1991) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1991.tb03161.x · Cited by 90 · see citing works
Risk of discontinuation of atypical antipsychotic agents in the treatment of schizophrenia
Mullins, C. D., Obeidat, N. A., Cuffel, B. J., Naradzay, J., & Loebel, A. D. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.04.035 · Cited by 75 · see citing works
Baloush-Kleinman, V., Levine, S. Z., Roe, D., Shnit, D., Weizman, A., & Poyurovsky, M. (2011) · Schizophrenia Research · doi:10.1016/j.schres.2011.04.030 · Cited by 73 · see citing works
Zhang, H., Mi, W., Li, L., Shi, Y., & Xiao, J. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s72367 · Cited by 72 · see citing works
Offord, S. J., Lin, J., Mirski, D. F., & Wong, B. J. O. (2013) · Advances in Therapy · doi:10.1007/s12325-013-0016-5 · Cited by 67 · see citing works
Jiang, Y., & Ni, W. (2015) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.1634 · Cited by 53 · see citing works
Peng, H., Long, Y., Li, J., Guo, Y., Wu, H., Yang, Y., Ding, Y., He, J., & Ning, Y. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-45 · Cited by 44 · see citing works
Self-citationMoisan, J., & Grégoire, J. (2010) · Clinical Therapeutics · doi:10.1016/j.clinthera.2010.01.003 · Cited by 41 · see citing works
Ran, M., Leff, J., Hou, Z., Xiang, M., & Chan, C. L.-W. (2003) · Culture Medicine and Psychiatry · doi:10.1023/a:1023636021995 · Cited by 30 · see citing works
Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan
Li, C., & Lewis, F. M. (2013) · Aging & Mental Health · doi:10.1080/13607863.2013.814098 · Cited by 30 · see citing works
Cooper, D., Moisan, J., Gaudet, M., Abdous, B., & Grégoire, J. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505001404 · Cited by 29 · see citing works
Predictors of help-seeking duration in adult-onset psychosis in Hong Kong
Hui, C. L. M., Tang, J. Y. ‐., Wong, G. H. Y., et al. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-013-0688-9 · Cited by 21 · see citing works
Olivares, J. M., Thirunavukarasu, Kulkarni, J., Yan, Y., Zhang, & Zhang (2013) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s49080 · Cited by 16 · see citing works
Health insurance in China: variation in co-payments and psychiatric hospital utilization.
Zhou, Y., Rosenheck, R. A., & He, H. (2014) · PubMed · Cited by 15 · see citing works
Self-citationFancher, T. L., Lee, D. L., Cheng, J. K. Y., Yang, M. S., & Yang, L. H. (2012) · Asian American Journal of Psychology · doi:10.1037/a0027803 · Cited by 14 · see citing works
Making health care affordable in China
Parry, J. E. (2008) · Bulletin of the World Health Organization · doi:10.2471/blt.08.011108 · Cited by 9 · see citing works
He, H., Zhou, Y., Sun, B., et al. (2015) · PubMed · doi:10.11919/j.issn.1002-0829.214138 · Cited by 7 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018) · World Psychiatry · doi:10.1002/wps.20508 · Cited by 247 · see citing works
- Authors
- Zhou, Y., Rosenheck, R., Mohamed, S., Ning, Y., & He, H.
- Affiliations
- Guangzhou Medical University (CN)
- Yale University (US)
- Corresponding author
- He, Hongbo
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 250
- Pages
- 129-135
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2577337095
- Cited by
- 23
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- 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 › Psychiatric care and mental health services
- Keywords
- schizophrenia, drug discontinuation, antipsychotic drugs, hospital discharge, relapse, insight into illness, disease duration, health insurance, caregiver burden, medication adherence, psychoeducation, treatment engagement
- MeSH terms
- Adolescent, Adult, Chronic Disease, Female, Humans, Male, Middle Aged, Patient Discharge, Patient Dropouts, Recurrence, Risk Factors, Schizophrenia, Antipsychotic Agents, Caregivers, Medication Adherence, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
