Treatment adherence in schizophrenia

A patient-level meta-analysis of combined CATIE and EUFEST studies

P. Czobor, Richard A. Van Dorn, Leslie Citrome, Rene S. Kahn, W. Wolfgang Fleischhacker, Jan Volavka

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients[U+05F3] data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p = 0.0003), higher levels of hostility (p = 0.0002), and impaired insight (p <0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients[U+05F3] insight and comorbid substance use and the establishment of therapeutic alliance.

Original languageEnglish
Pages (from-to)1158-1166
Number of pages9
JournalEuropean Neuropsychopharmacology
Volume25
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

Fingerprint

Antipsychotic Agents
Meta-Analysis
Schizophrenia
Clinical Trials
Hostility
Pharmacology
Therapeutics
Psychomotor Agitation
Dyskinesias
Parkinsonian Disorders
Therapeutic Uses
Logistic Models

Keywords

  • Adherence
  • Antipsychotic
  • Compliance
  • Hostility
  • Insight
  • Schizophrenia

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Biological Psychiatry
  • Neurology
  • Pharmacology

Cite this

Treatment adherence in schizophrenia : A patient-level meta-analysis of combined CATIE and EUFEST studies. / Czobor, P.; Van Dorn, Richard A.; Citrome, Leslie; Kahn, Rene S.; Fleischhacker, W. Wolfgang; Volavka, Jan.

In: European Neuropsychopharmacology, Vol. 25, No. 8, 01.08.2015, p. 1158-1166.

Research output: Contribution to journalArticle

Czobor, P. ; Van Dorn, Richard A. ; Citrome, Leslie ; Kahn, Rene S. ; Fleischhacker, W. Wolfgang ; Volavka, Jan. / Treatment adherence in schizophrenia : A patient-level meta-analysis of combined CATIE and EUFEST studies. In: European Neuropsychopharmacology. 2015 ; Vol. 25, No. 8. pp. 1158-1166.
@article{d6743c2361244378aba9228f6c20f72a,
title = "Treatment adherence in schizophrenia: A patient-level meta-analysis of combined CATIE and EUFEST studies",
abstract = "The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients[U+05F3] data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p = 0.0003), higher levels of hostility (p = 0.0002), and impaired insight (p <0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients[U+05F3] insight and comorbid substance use and the establishment of therapeutic alliance.",
keywords = "Adherence, Antipsychotic, Compliance, Hostility, Insight, Schizophrenia",
author = "P. Czobor and {Van Dorn}, {Richard A.} and Leslie Citrome and Kahn, {Rene S.} and Fleischhacker, {W. Wolfgang} and Jan Volavka",
year = "2015",
month = "8",
day = "1",
doi = "10.1016/j.euroneuro.2015.04.003",
language = "English",
volume = "25",
pages = "1158--1166",
journal = "European Neuropsychopharmacology",
issn = "0924-977X",
publisher = "Elsevier",
number = "8",

}

TY - JOUR

T1 - Treatment adherence in schizophrenia

T2 - A patient-level meta-analysis of combined CATIE and EUFEST studies

AU - Czobor, P.

AU - Van Dorn, Richard A.

AU - Citrome, Leslie

AU - Kahn, Rene S.

AU - Fleischhacker, W. Wolfgang

AU - Volavka, Jan

PY - 2015/8/1

Y1 - 2015/8/1

N2 - The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients[U+05F3] data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p = 0.0003), higher levels of hostility (p = 0.0002), and impaired insight (p <0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients[U+05F3] insight and comorbid substance use and the establishment of therapeutic alliance.

AB - The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients[U+05F3] data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p = 0.0003), higher levels of hostility (p = 0.0002), and impaired insight (p <0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients[U+05F3] insight and comorbid substance use and the establishment of therapeutic alliance.

KW - Adherence

KW - Antipsychotic

KW - Compliance

KW - Hostility

KW - Insight

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=84938746749&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938746749&partnerID=8YFLogxK

U2 - 10.1016/j.euroneuro.2015.04.003

DO - 10.1016/j.euroneuro.2015.04.003

M3 - Article

VL - 25

SP - 1158

EP - 1166

JO - European Neuropsychopharmacology

JF - European Neuropsychopharmacology

SN - 0924-977X

IS - 8

ER -