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Adherence in psychiatry

Published online by Cambridge University Press:  13 June 2014

Richard Duffy  and
Brendan D Kelly
Richard Duffy
Affiliation:
Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland
Brendan D Kelly*
Affiliation:
Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland
*
*Correspondence E-mail: brendankelly35@gmail.com
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Abstract

The word ‘adherence’ refers to the provision of consistent support (eg. for a political party or religion) or the act of holding particular elements together (eg. in constructing a building). In the medical context, adherence refers to the extent to which patients take their medications as prescribed. While the terminology related to medical adherence has changed significantly over the past two millennia, the core issue has not. Most recently, the term ‘adherence’ has replaced the term ‘compliance’, although it still jostles with ‘concordance’ in a growing literature which focuses now, as always, on one key question: why do so many people seek treatment for illness but then decide not to take their prescribed medication? This is an important question, both in terms of public health and societal cost: in the US, up to 50% of patients do not take their prescribed medications, resulting in additional healthcare costs of $290 billion per year. The greatest cost of non-adherence, however, relates to prolonged illness, increased rates of relapse and reduced wellness.

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Type
Continuing Professional Development
Information
Irish Journal of Psychological Medicine , Volume 27 , Issue 1 , March 2010 , pp. i - vii
Copyright
Copyright © Cambridge University Press 2010

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References

1.Gove, PB (ed.). Webster's Third New International Dictionary. Springfield, MA: Merham Webster, 2008.Google Scholar
2.Osterberg, L, Blaschke, T. Adherence to medication. N Engl J Med. 2005; 353: 487–497.CrossRefGoogle ScholarPubMed
3.Adams, SG, Howe, JT. Predicting medication compliance in a psychiatric population. J Nerv Dis 1993;181:558–60.CrossRefGoogle Scholar
4.Osterberg, L, Blaschke, T. Adherence to medication. N Engl J Med 2005 Aug 4; 353: 487–97.CrossRefGoogle ScholarPubMed
5.New England Healthcare Institute. Thinking Outside the Pillbox A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease A NEHI Research Brief. Cambridge, MA: New England Healthcare Institute, 2009.Google Scholar
6.Cramer, JA, Rosenheck, R. Compliance with medication regimens for mental and physical disorders. Psychiatr Serv 1998; 49:196–201.CrossRefGoogle ScholarPubMed
7.Colom F, Gastó C, Vieta, E, Martínez-Arán, A, Reinares, M, Benabarre, A. Clinical factors associated with treatment noncompliance in euthymic bipolar patients. J Clin Psychiatry 2000; 61 : 549–55.CrossRefGoogle ScholarPubMed
8.Dosse, C, Cesarino, CB, Martin, JF, Castedo, MC. Factors associated to patients' noncompliance with hypertension treatment. Rev Lat Am Enfermagem 2009; 17: 201–6.CrossRefGoogle ScholarPubMed
9.Vergouwen, AC, van Hout, HP, Baker, A. Methods to improve patient compliance in the use of antidepressants. Ned Tijdschr Geneeskd 2002; 146: 204–207. (in Dutch)Google ScholarPubMed
10.Weiden, PJ, Olfson, M. Cost of relapse in schizophrenia. Schizophr Bull 1995; 21 : 419–429.CrossRefGoogle ScholarPubMed
11.Buchanan, A. A two year prospective study of treatment compliance in patients with schizophrenia. Psychol Med 1992; 22: 787–797.CrossRefGoogle ScholarPubMed
12.Urquhart, J. The electronic medication event monitor: lessons for pharmacotherapy. Clin Pharmacokinet 1997; 32: 345–356.CrossRefGoogle ScholarPubMed
13.van Servellen, G, Chang, B, Garcia, L, Lombardi, E. Individual and system level factors associated with treatment nonadherence in human immunodeficiency virus-infected men and women. AIDS patient care STDS 2002; 16: 269–281.CrossRefGoogle ScholarPubMed
14.Stilley, CS, Sereika, S, Muldoon, MF, Ryan, CM, Dunbar-Jacob, J. Psychological and cognitive function: predictors of adherence with cholesterol lowering treatment. Ann Behav Med 2004; 27: 117–124.CrossRefGoogle ScholarPubMed
15.Sewitch, MJ, Abrahamowicz, M, Barkun, A, Bitton, A, Wild, GA, Cohen, A. Patient nonadherence to medication in inflammatory bowel disease. Am J Gastroenterol 2003; 98: 1535–1544.CrossRefGoogle ScholarPubMed
16.Lacro, JP, Dunn, LB, Dolder, CR, Leckband, SG, Jeste, DV. Prevalence of and risk factor for medication non adherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 2002; 63: 1121–1128.CrossRefGoogle ScholarPubMed
17.Okuno, J, Yangi, H, Tomura, S. Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community? Eur J Clin Pharmacol 2001; 57: 589–594.CrossRefGoogle ScholarPubMed
18.Okuno, J, Yangi, H, Tomura, S. Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community? Eur J Clin Pharmacol 2001; 57: 589–594.CrossRefGoogle ScholarPubMed
19.Stilley, CS, Sereika, S, Muldoon, MF, Ryan, CM, Dunbar-Jacob, J. Psychological and cognitive function: predictors of adherence with cholesterol lowering treatment. Ann Behav Med 2004; 27: 117–124.CrossRefGoogle ScholarPubMed
20.Balkrishnan, R. Predictors of medication adherence in the elderly. Clin Ther 1998; 20: 764–771.CrossRefGoogle ScholarPubMed
21.Ammassari, A, Trotta, MP, Murri, R, Castelli, F, Narciso, P, Noto, P, Vecchiet, J, D'Arminio, , Monforte, A, Wu, AW, Antinori, A. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. J Acquir Immune Dific Syndr 2002; 31 {Suppl 3): 123–127.CrossRefGoogle ScholarPubMed
22.Van Servellen, G, Chang, B, Garcia, L, Lombardi, E. Individual and system level factors associated with treatment nonadherence in human immunodeficiency virusinfected men and women. AIDS Patient Care STDS 2002; 16: 269–281.CrossRefGoogle ScholarPubMed
23.Balkrishnan, R. Predictors of medication adherence in the elderly. Clin Ther 1998; 20: 764–771.CrossRefGoogle ScholarPubMed
24.Kamali, M, Kelly, BD, Clarke, M, Browne, S, Gervin, M, Kinsella, A, Lane, A, Larkin, C, O'Callaghan, E. A prospective evaluation of adherence to medication in first episode schizophrenia. Eur Psychiatry 2006; 21 : 29–33.CrossRefGoogle ScholarPubMed
25.Nunes, V, Neilson, J, O'Flynn, N, Calvert, N, Kuntze, S, Smithson, H, Benson, J, Blair, J, Bowser, A, Clyne, W, Crome, P, Haddad, P, Hemingway, S, Home, R, Johnson, S, Kelly, S, Packham, B, Patel, M, Steel, J (2009). Clinical Guidelines and Evidence Review for Medicines Adherence: involving patients in decisions about prescribed medicines and supporting adherence. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners.Google Scholar
26.Wagner, JH, Justice, AC, Chesney, M, Sinclair, G, Weisman, S, Rodriguez-Barradas, M. Patient and provider-reported adherence: towards a clinically useful approach to measuring antiretroviral adherence. J Clin Epidemiol 2001; 54 (Suppl 1): 91–98.CrossRefGoogle Scholar
27.Alcoba, M, Cuevas, MJ, Perez-Simon, MR, Mostaza, JL, Ortega, L, Ortiz de, Urbina J, Carro, JA, Raya, C, Abad, M, Martin, V. Assessment to adherence to triple anti-retroviral treatment including indinavir: role of determination of plasma levels of indinavir. J Acquir Immune Defic Syndr 2003; 33: 253–258.CrossRefGoogle Scholar
28.Osterberg, L, Blaschke, T. Adherence to medication. N Engl J Med. 2005; 353: 487–497.CrossRefGoogle ScholarPubMed
29.Talyor, D. Pharmacokinetic interactions involving clozapine. Br J Psychiatry 1997; 171: 109–112.CrossRefGoogle Scholar
30.Taylor, D, Paton, C, Kerwin, R. The Maudsley prescribing guidelines 9th edition. United Kingdom. Informa Healthcare.Google Scholar
31.Taylor, D, Duncan, D. Doses of carbamazepine and valproate in bipolar affective disorder. Psychiatr Bull 1997; 21 : 221–223.CrossRefGoogle Scholar
32.Taylor, D, Paton, C, Kerwin, R. The Maudsley prescribing guidelines 9th edition. United Kingdom. Informa Healthcare.Google Scholar
33.La Fleur, J. Methods to measure patient compliance with medication regimens. J Pain Palliat Care Pharmacother 2004;18: 81–87.CrossRefGoogle ScholarPubMed
34.Farmer, KC. Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther 1999; 21 : 1074–1090.CrossRefGoogle ScholarPubMed
35.Farmer, KC. Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther 1999; 21 : 1074–1090CrossRefGoogle ScholarPubMed
36.Bennett-Johnson, SB. Methodological Issues in diabetes research. Diabetes Care 1992; 15: 1658–1667.CrossRefGoogle Scholar
37.La Fleur, J. Methods to measure patient compliance with medication regimens. J Pain Palliat Care Pharmacother 2004;18: 81–87.CrossRefGoogle ScholarPubMed
38.Hawkshead, J, Krousel-Wood, MA. Techniques for measuring medication adherence in hypertensive patients in out patient setting: advantages and limitations. Dis Manag Health Out 2007; 15: 109–118.CrossRefGoogle Scholar
39.Farmer, KC. Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther 1999; 21 : 1074–1090.CrossRefGoogle ScholarPubMed
40.Bennett-Johnson, SB. Methodological Issues in diabetes research. Diabetes Care 1992; 15: 1658–1667.CrossRefGoogle Scholar
41.Hecht, FM. Measuring HIV treatment adherence in clinical practice. AIDS Clin Care 1998; 10: 57–59.Google ScholarPubMed
42.Osterberg, L, Blaschke, T. Adherence to medication. N Engl J Med. 2005; 353: 487–497.CrossRefGoogle ScholarPubMed
43.Hawkshead, J, Krousel-Wood, MA. Techniques for measuring medication adherence in hypertensive patients in out patient setting: advantages and limitations. Dis Manag Health Out 2007; 15: 109–118.CrossRefGoogle Scholar
44.Velligan, Dl, Diamond, PM, Mintz, J, Maples, N, Li, X, Zeber, J, Ereshefsky, L, Lam, YF, Castillo, D, Miller, AL. The use of individually tailored environmental supports to improve medication adherence and outcomes in schizophrenia. Schizophr Bull. 2008; 34: 483–493CrossRefGoogle ScholarPubMed
45.Carlucci, JG, Kamanga, BS, Sheneberger, R, Shepherd, BE, Jenkins, CA, Spurrier, J, Vermund, SH. Predictors of Adherence to Antiretroviral Therapy in Rural Zambia. J Acquir Immune Defic Syndr 2008; 47: 615–22.CrossRefGoogle ScholarPubMed
46.Cramer, JA, Mattson, RH, Prevey, ML, Scheyer, RD, Oulette, VL. How often is medication taken as prescribed? A novel assessment technique. JAMA 1989; 261: 3273–7.CrossRefGoogle ScholarPubMed
47.Diaz, E, Levine, HB, Sullivan, MC, Sernyak, MJ, Hawkins, , Cramer, JA, Woods, SW. Use of the Medication Event Monitoring System to estimate medication compliance in patients with schizophrenia. J Psychiatry Neurosci 2001; 26: 325–329.Google ScholarPubMed
48.Pullar, T, Kumar, S, Tindall, H, Feely, M. Time to stop counting the tablets? Clin Pharmacol Ther 1989; 46: 163–168.Google Scholar
49.Steiner, JF, Prochazka, AV. The assessment of refill compliance using pharmacy records: methods, validity and applications. J Clin Epidemiol 1997; 50: 105–116.CrossRefGoogle ScholarPubMed
50.Lau, HS, de Boer, A, Beuning, KS, Porsius, A. Validation of pharmacy records in drug exposure assessment. J Clin Epidemiol 1997; 50: 619–625.CrossRefGoogle ScholarPubMed
51.Chan, DC, Shrank, WH, Cutler, D, Jan, S, Fischer, MA,Liu, J, Avorn, J, Solomon, D, Brookhart, MA, Choudhry, NK. Patient, Physician, and Payment Predictors of Statin Adherence. Med Care 2009, Nov 18. [Epub ahead of print]Google Scholar
52.Kasper, S, Saya, L, Tekin, B, Loze, JY. How to improve adherence to antipsychotic treatment: Outcomes of the Improving Patient outcomes in psychiatry (IMPACT)Berlin 2009 meeting workshop. Int J Psychiatry Clin Pract 2009; 13; 245–252.CrossRefGoogle ScholarPubMed
53.Shi, L, Hudges, M, Yurgin, N, Boye, KS. Impact of dose frequency on compliance and health outcomes: a literature review (1966-2006). Expert Rev Pharmacoeconomics Outcomes Res 2007; 7: 187–202.CrossRefGoogle ScholarPubMed
54.Claxton, A, Cramer, J, Pierce, C. A systematic review of the association between dose regimens and medication compliance. Clin Ther 2001; 12: 1296.CrossRefGoogle Scholar
55.Schroder, K, Fahey, T, Ebrahim, S. How can we improve Adherence to blood pressure-lowering medication in ambulatory care? Systematic Review of the randomized controlled trials. Arch Intern Med 2004; 164: 722–732.CrossRefGoogle Scholar
56.Newhouse, JP. Free for all? Lessons from the RAND health insurance experiment. Cambridge, MA: Harvard University Press, 1993.Google Scholar
57.Hirth, RA, Greer, SL, Albert, JM, Young, EW, Piette, JD. Out-of- pocket spending and medication adherence among dialysis patients in twelve countries. Health Aff 2008; 27: 89–102.CrossRefGoogle ScholarPubMed
58.Atella, V, Schafheutle, E, Noyce, P, Hassell, K. Affordability of medicines and patients' costreducing behaviour: empirical evidence based on SUR estimates from Italy and the UK. Appl Health Econ Health Policy 2005; 4: 23–35.CrossRefGoogle ScholarPubMed
59.Kelly, BD. Structural violence and schizophrenia. Soc Sci Med 2005; 61 : 721–30CrossRefGoogle ScholarPubMed
60.O'Donnell, C, Donohoe, G, Sharkey, L, Owens, N, Migone, M, Harries, R, Kinsella, A, Larkin, C, O'Callaghan, E. Compliance therapy: a randomised controlled trial in schizophrenia. BMJ 2003;327: 834.CrossRefGoogle ScholarPubMed
61.Shon, KH, Park, SS. Medication and symptom management education program for the rehabilitation of psychiatric patients in Korea: the effects of promoting schedule on self-efficacy theory. Yonsei Med J 2002; 43: 578–589.CrossRefGoogle ScholarPubMed
62.Lanouette, NM, Folsom, DP, Sciolla, A, Jeste, DV. Psychotropic medication nonadherence among United States Latinos: a comprehensive literature review. Psychiatr Serv 2009;60: 157–74.CrossRefGoogle ScholarPubMed
63.Ran, MS, Xiang, MZ, Chan, CL, Leff, J, Simpson, P, Huang, MS, Shan, YH, Li, SG. Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia – a randomised control trail. SocPsychiatry Psychiatr Epidemiol 2003; 38: 69–75.CrossRefGoogle Scholar
64.Carrá, G, Montomoli, C, Clerici, M, Cazzullo, CL. Family interventions for schizophrenia in Italy: randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2007; 257: 23–30.CrossRefGoogle ScholarPubMed
65.Lanouette, NM, Folsom, DP, Sciolla, A, Jeste, DV. Psychotropic medication nonadherence among United States Latinos: a comprehensive literature review. Psychiatr Serv 2009;60: 157–74.CrossRefGoogle ScholarPubMed
66.Lee, JK, Grace, KA, Taylor, AJ. Effect of a pharmacy care programon medication adherence and persistence, blood pressure and low-density lipoprotein cholesterol: a randomised controlled trial. JAMA 2006; 296: 2563–2571.CrossRefGoogle Scholar
67.Orton, L, Barnish, G. Unit-dose packaged drugs for treating malaria. Cochrane Database Syst Rev 2005; 2: CD004614CrossRefGoogle Scholar
68.Heneghan, CJ, Glasziou, P, Perera, R. Reminder packaging for improving adherence to selfadministered long-term medications. Cochrane Database Syst Rev 2006; 1: CD005025.CrossRefGoogle Scholar
69.Nunes, V, Neilson, J, O'Flynn, N, Calvert, N, Kuntze, S, Smithson, H, Benson, J, Blair, J, Bowser, A, Clyne, W, Crome, P, Haddad, P, Hemingway, S, Home, R, Johnson, S, Kelly, S, Packham, B, Patel, M, Steel, J (2009). Clinical Guidelines and Evidence Review for Medicines Adherence: involving patients in decisions about prescribed medicines and supporting adherence. London: National Collaborating Centre forPrimary Care and Royal College of General Practitioners.Google Scholar
70.Bangalore, S, Kamalakkannan, G, Parkar, S, Messerii, FH. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med 2007; 120: 713–19.CrossRefGoogle ScholarPubMed
71.Nunes, V, Neilson, J, O'Flynn, N, Calvert, N, Kuntze, S, Smithson, H, Benson, J, Blair, J, Bowser, A, Clyne, W, Crome, P, Haddad, P, Hemingway, S, Home, R, Johnson, S, Kelly, S, Packham, B, Patel, M, Steel, J (2009). Clinical Guidelines and Evidence Review for Medicines Adherence: involving patients in decisions about prescribed medicines and supporting adherence. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners. Section 8.9.Google Scholar
72.Brown, BG, Bardsley, J, Poulin, D, Hillger, LA, Dowdy, A, Maher, VM, Zhao, XQ, Albers, JJ, Knopp, RH. Moderate dose, three drug therapy with niacin, lovastatin, and colestipol to reduce low-density lipoprotein cholesterol < 100 mg/dl in patients with hyperlipidemia and coronary artery disease. Am J Cardiol. 1997; 80:111–115.CrossRefGoogle ScholarPubMed
73.Nunes, V, Neilson, J, O'Flynn, N, Calvert, N, Kuntze, S, Smithson, H, Benson, J, Blair, J, Bowser, A, Clyne, W, Crome, P, Haddad, P, Hemingway, S, Home, R, Johnson, S, Kelly, S, Packham, B, Patel, M, Steel, J (2009). Clinical Guidelines and Evidence Review for Medicines Adherence: involving patients in decisions about prescribed medicines and supporting adherence. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners. Section 8.10Google Scholar
74.Armstrong, AW, Watson, AJ, Makredes, M, Frangos, JE, Kimball, AB, Kvedar, JC. Text-message reminders to improve sunscreen use: a randomized, controlled trial using electronic monitoring. Arch Dermatol 2009; 145: 1230–6.CrossRefGoogle ScholarPubMed
75.Sirriyeh, R, Lawton, R, Ward, J. Physical activity and adolescents: An exploratory randomized controlled trial investigating the influence of affective and instrumental text messages. Br J Health Psychol 2010, Feb 12. [Epub ahead of print].Google Scholar
76.Strandbygaard, U, Thomsen, SF, Backer, V. A daily SMS reminder increases adherence to asthma treatment: a three-month follow-up study. Respir Med 2010; 104: 166–71.CrossRefGoogle ScholarPubMed
77.Neimark, G. Patients and Text Messaging: A Boundary Issue. Am J Psychiatry 2009; 166: 1298–9CrossRefGoogle ScholarPubMed
78.Giuffrida, A, Torgerson, DJ. Should we pay the patient? Review of financial incentives to enhance patient compliance. BMJ 1997; 315: 703–707.CrossRefGoogle ScholarPubMed
79.Higgins, ST, Budney, AJ, Bickle, WK, Foerg, FE, Donham, R, Badger, GJ. Incentives improve outcome in outpatient behavioural treatment of cocaine dependence. Arch Gen Psychiatry 1994; 51:568–576.CrossRefGoogle ScholarPubMed
80.Nunes, V, Neilson, J, O'Flynn, N, Calvert, N, Kuntze, S, Smithson, H, Benson, J, Blair, J, Bowser, A, Clyne, W, Crome, P, Haddad, P, Hemingway, S, Home, R, Johnson, S, Kelly, S, Packham, B, Patel, M, Steel, J (2009). Clinical Guidelines and Evidence Review for Medicines Adherence: involving patients in decisions about prescribed medicines and supporting adherence. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners. Section 8.Google Scholar
81.McCartney, M. The real deal. Financial Times 2009; November 13.Google Scholar
82.Yamada, K, Watanabe, K, Nemoto, N, Fujita, H, Chikaraishi, C, Yamauchi, K, Yagi, G, Asai M, Kanba S. Prediction of medication noncompliance in outpatients with schizophrenia: 2-year follow-up study. Psychiatry Res 2006; 141:61–69.CrossRefGoogle ScholarPubMed
83.Perkins, DO. Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry 2002; 63: 1121–1128.CrossRefGoogle ScholarPubMed
84.Nemeroff, CB. Improving antidepressant adherence. J Clin Psychiatry 2003; 64 (Suppl 18): 25–30.Google ScholarPubMed
85.Segador, J, Gil-Guillen, VF, Orozco, D, Quirce, F, Carratala, MC, Fernandez-Parker, A, Merino, J. The effect of written information on adherence to antibiotic treatment in acute sore throat. Int J Antmicrob Agents 2005; 26: 56–61.CrossRefGoogle ScholarPubMed
86.Schaffer, SD, Tian, L. Promoting adherence: effects of theory-based asthma education. Clin Nurs Res 2004; 13:69–89.CrossRefGoogle ScholarPubMed
87.Bosch-Capblanch, X, Abba, K, Prictor, M, Garner, P. Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and healthcare promotion activites. Cochrane Database Syst Rev 2007; 2: CD004808.Google Scholar
88.Melnikow, J, Kiefe, C. Patient compliance and medical research: issues in methodology. J Gen Intern Med 1994; 9: 96–105.CrossRefGoogle ScholarPubMed