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A patient perspective of the impact of medication side effects on adherence: results of a cross-sectional nationwide survey of patients with schizophrenia
Open accessAbstract
BACKGROUND: Antipsychotic medications often have a variety of side effects, however, it is not well understood how the presence of specific side effects correlate with adherence in a real-world setting. The aim of the current study was to examine the relationship between these variables among community-dwelling patients with schizophrenia. METHODS: Data were analyzed from a 2007-2008 nationwide survey of adults who self-reported a diagnosis of schizophrenia and were currently using an antipsychotic medication (N = 876). The presence of side effects was defined as those in which the patient reported they were at least "somewhat bothered". Adherence was defined as a score of zero on the Morisky Medication Adherence Scale. To assess the relationship between side effects and adherence, individual logistic regression models were fitted for each side effect controlling for patient characteristics. A single logistic regression model assessed the relationship between side effect clusters and adherence. The relationships between adherence and health resource use were also examined. RESULTS: A majority of patients reported experiencing at least one side effect due to their medication (86.19%). Only 42.5% reported complete adherence. Most side effects were associated with a significantly reduced likelihood of adherence. When grouped as side effect clusters in a single model, extra pyramidal symptoms (EPS)/agitation (odds ratio (OR) = 0.57, p = 0.0007), sedation/cognition (OR = 0.70, p = 0.033), prolactin/endocrine (OR = 0.69, p = 0.0342), and metabolic side effects (OR = 0.64, p = 0.0079) were all significantly related with lower rates of adherence. Those who reported complete adherence to their medication were significantly less likely to report a hospitalization for a mental health reason (OR = 0.51, p = 0.0006), a hospitalization for a non-mental health reason (OR = 0.43, p = 0.0002), and an emergency room (ER) visit for a mental health reason (OR = 0.60, p = 0.008). CONCLUSIONS: Among patients with schizophrenia, medication side effects are highly prevalent and significantly associated with medication nonadherence. Nonadherence is significantly associated with increased healthcare resource use. Prevention, identification, and effective management of medication-induced side effects are important to maximize adherence and reduce health resource use in schizophrenia.
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“Likewise, in five studies, weight gain was another medication-related side-effect that associated with medication non-adherence and patients’ perception toward their medication [25, 33, 36, 44, 55].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [33]
In the citing paper
“In seven studies, patients feeling dizziness, fatigue, tiredness, sedation, lethargy, and sleepiness were the most frequently reported side-effects that contributed to medication non-adherence [11, 33, 36, 37, 50, 52, 65].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [33]
In the citing paper
“In two studies, side-effects such as decreased sexual interest and having a symptom of sexual dysfunction were associated with patients’ medication adherence [33, 36].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [33]
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Metadata
- Authors
- DiBonaventura, M., Gabriel, S., Dupclay, L., Gupta, S., & Kim, E.
- Affiliations
- Kantar Health (United States) (US)
- Novartis (United States) (US)
- Corresponding author
- DiBonaventura, Marco
- Venue
- BMC Psychiatry
- Published
- 2012-03-20
- Volume
- 12
- Issue
- 1
- Pages
- 20-20
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC3342101
- OpenAlex
- W2157910519
- Cited by
- 333
- References
- 31
- Citations by year
- 2026: 16 · 2025: 30 · 2024: 32 · 2023: 27 · 2022: 22 · 2021: 34 · 2020: 22 · 2019: 27 · 2018: 22 · 2017: 20 · 2016: 24 · 2015: 22 · 2014: 13 · 2013: 19 · 2012: 2
- FWCI
- 15.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- schizophrenia, antipsychotic adverse effects, medication adherence, medication non-adherence, sedation, prolactin, metabolic side effects, health care utilization, hospitalization, emergency department visits, patient perspectives, community-dwelling patients, Morisky Medication Adherence Scale, health care costs, quality of life
- MeSH terms
- Adult, Attitude to Health, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Middle Aged, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Medication Adherence
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