The DOI matches its Crossref record; 74 of the 74 references it cites were found in a registry or an index.
Prevalence of and Risk Factors for Medication Nonadherence in Patients With Schizophrenia: A Comprehensive Review of Recent Literature
Abstract
OBJECTIVE: Nonadherence to prescribed antipsychotic medications places patients with schizophrenia at a greatly increased risk of illness exacerbation and rehospitalization. Identification of risk factors for nonadherence is an initial step toward designing effective interventions. This article reviews recent literature on the prevalence of and risk factors for medication nonadherence in patients with schizophrenia. DATA SOURCES: We searched the MEDLINE/HealthSTAR and PsycINFO databases using combinations of the keywords risk factor(s), adherence, compliance, antipsychotic, neuroleptic, schizophrenia, and psychosis for articles published since 1980 that identified risk factors for medication nonadherence in schizophrenia patients. We included reports that (1) were published in English and (2) specifically examined risk factors for medication nonadherence. Thirty-nine articles met our selection criteria. DATA SYNTHESIS: Among the 10 reports that met a strict set of study inclusion criteria, we found a mean rate of nonadherence of 41.2%; the 5 reports that met a stricter set of inclusion criteria had a mean nonadherence rate of 49.5%. In the 39 articles reviewed, factors most consistently associated with nonadherence included poor insight, negative attitude or subjective response toward medication, previous nonadherence, substance abuse, shorter illness duration, inadequate discharge planning or aftercare environment, and poorer therapeutic alliance. Findings regarding an association between adherence and medication type were inconclusive, although few studies explored this relationship. Other factors such as age, gender, ethnicity, marital status, education level, neurocognitive impairment, severity of psychotic symptoms, severity of medication side effects, higher antipsychotic dose, presence of mood symptoms, route of medication administration, and family involvement were not found to be consistent predictors of nonadherence. Limitations of the published literature are discussed. CONCLUSION: Efforts to improve medication adherence in patients with schizophrenia should target relevant risk factors.
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In the citing paper
“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 [6]
In the citing paper
“Similarly, medication non-adherence is consistently associated with patients behavioral practices (e.g., substance abuse) [14, 74] and also patients’ socio-demographic characteristics (such as educational status, age, gender, and employment) [14, 72].”
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 [14]
In the citing paper
“In the present systematic review, medication non-adherence is associated with poor functioning of the health system such as lack of psychotherapy, lack of information, long treatment duration with little health personnel follow-up, inadequate discharge planning, increased hospitalizations, poor support and care environment, experiencing access barriers to high-quality care and health care”
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 [14]
In the citing paper
“This systematic review of factors influencing psychotropic medication non-adherence which is consistent with other systematic reviews [14, 72, 73, 77] has shown that medication adherence is mainly affected by patients’ negative attitude toward their medication, lack of insight, negative health belief, and perceived stigma.”
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 [14]
In the citing paper
“The present systematic review and meta-analysis finding is consistent with a finding from a comprehensive systematic review on schizophrenia which reported that a mean rate of non-adherence was 41.2%.”
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 [14]
In the citing paper
“In addition, medication non-adherence is associated with clinical- or medication-related factors [14, 72–74, 77].”
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 [14]
In the citing paper
“The sub-group analysis indicated that a mean non-adherence rate was 49.5% [14]”
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 [14]
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Cited by
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Osterberg, L., & Blaschke, T. (2005) · New England Journal of Medicine · doi:10.1056/nejmra050100 · Cited by 7,974
Determinants of patient adherence: a review of systematic reviews
Kardas, P., Lewek, P., & Matyjaszczyk, M. (2013) · Frontiers in Pharmacology · doi:10.3389/fphar.2013.00091 · Cited by 809
“…referral (Pampallona et al., 2002) Obtaining certification of preventive treatment (for immigrants to US) (Munro et al., 2007) Access to care (Lacro et al., 2002) Greater distance from the clinic (Jindal et al., 2003; Munro et al., 2007) Current inpatient status (Lacro et al., 2002) Rural…”
BackgroundInfluentialLysaker, P. H., Roe, D., & Yanos, P. T. (2006) · Schizophrenia Bulletin · doi:10.1093/schbul/sbl016 · Cited by 688
Patient adherence to medical treatment: a review of reviews
van Dulmen, S., Sluijs, E., van Dijk, L., de Ridder, D., Heerdink, R., & Bensing, J. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-55 · Cited by 627
“Overviews of the number of non-adherent patients can be found in various reviews [10-14].”
Psychoeducation for schizophrenia
Xia, J., Merinder, L. B., & Belgamwar, M. R. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002831.pub2 · Cited by 669
Metadata
- Authors
- Lacro, J. P., Dunn, L. B., Dolder, C. R., Leckband, S. G., & Jeste, D. V.
- Affiliations
- University of California San Diego (US)
- VA San Diego Healthcare System (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2002-10-15
- Volume
- 63
- Issue
- 10
- Pages
- 892-909
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2070893229
- Cited by
- 1,383
- References
- 74
- Citations by year
- 2026: 42 · 2025: 29 · 2024: 43 · 2023: 55 · 2022: 59 · 2021: 58 · 2020: 63 · 2019: 52 · 2018: 56 · 2017: 65 · 2016: 80 · 2015: 74 · 2014: 57 · 2013: 103 · 2012: 97
- FWCI
- 18.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r29mh056938-04)
- National Institute of Mental Health (MH49671, R01MH059101, MH-43693, MH56938, MH59101, P30MH049671, MH-19934, T32MH019934)
- 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 › Mental Health Treatment and Access
- Keywords
- medication non-adherence, schizophrenia, antipsychotic drugs, risk factors, prevalence, lack of insight, substance abuse, therapeutic relationship, aftercare planning, hospital readmission
- MeSH terms
- Adult, Ambulatory Care, Factor Analysis, Statistical, Female, Hospitalization, Humans, Male, Probability, Research Design, Risk Factors, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Prevalence, Treatment Refusal
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