Drug attitude and other predictors of medication adherence in schizophrenia : 12 months of electronic monitoring (MEMS(®)) in the Swedish COAST-study
(2013) In European Neuropsychopharmacology 23(12). p.62-1754- Abstract
The aim was to investigate clinical predictors of adherence to antipsychotics. Medication use was electronically monitored with a Medication Event Monitoring System (MEMS(®)) for 12 months in 112 outpatients with schizophrenia and schizophrenia-like psychosis according to DSM-IV. Symptom burden, insight, psychosocial function (PSP) and side effects were rated at baseline. A comprehensive neuropsychological test battery was administered and a global composite score was calculated. The Drug Attitude Inventory (DAI-10) was filled in. A slightly modified DAI-10 version for informants was distributed as a postal questionnaire. Non-adherence (MEMS(®) adherence ≤0.80) was observed in 27%. In univariate regression models low scores on DAI-10... (More)
The aim was to investigate clinical predictors of adherence to antipsychotics. Medication use was electronically monitored with a Medication Event Monitoring System (MEMS(®)) for 12 months in 112 outpatients with schizophrenia and schizophrenia-like psychosis according to DSM-IV. Symptom burden, insight, psychosocial function (PSP) and side effects were rated at baseline. A comprehensive neuropsychological test battery was administered and a global composite score was calculated. The Drug Attitude Inventory (DAI-10) was filled in. A slightly modified DAI-10 version for informants was distributed as a postal questionnaire. Non-adherence (MEMS(®) adherence ≤0.80) was observed in 27%. In univariate regression models low scores on DAI-10 and DAI-10 informant, higher positive symptom burden, poor function, psychiatric side effects and lack of insight predicted non-adherence. No association was observed with global cognitive function. In multivariate regression models, low patient-rated DAI-10 and PSP scores emerged as predictors of non-adherence. A ROC analysis showed that DAI-10 had a moderate ability to correctly identify non-adherent patients (AUC=0.73, p<0.001). At the most "optimal" cut-off of 4, one-third of the adherent would falsely be identified as non-adherent. A somewhat larger AUC (0.78, p<0.001) was observed when the ROC procedure was applied to the final regression model including DAI-10 and PSP. For the subgroup with informant data, the AUC for the DAI-10 informant version was 0.68 (p=0.021). Non-adherence cannot be properly predicted in the clinical setting on the basis of these instruments alone. The DAI-10 informant questionnaire needs further testing.
(Less)
- author
- Brain, Cecilia ; Allerby, Katarina ; Sameby, Birgitta ; Quinlan, Patrick ; Joas, Erik ; Karilampi, Ulla ; Lindström, Eva ; Eberhard, Jonas LU ; Burns, Tom and Waern, Margda
- publishing date
- 2013-12
- type
- Contribution to journal
- publication status
- published
- keywords
- Adult, Aged, Antipsychotic Agents, Area Under Curve, Attitude to Health, Female, Follow-Up Studies, Humans, Male, Medication Adherence, Micro-Electrical-Mechanical Systems, Middle Aged, Neuropsychological Tests, Predictive Value of Tests, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Surveys and Questionnaires, Sweden, Young Adult
- in
- European Neuropsychopharmacology
- volume
- 23
- issue
- 12
- pages
- 9 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:24091164
- scopus:84887608510
- ISSN
- 1873-7862
- DOI
- 10.1016/j.euroneuro.2013.09.001
- language
- English
- LU publication?
- no
- id
- 3c57db5f-8331-4e64-b032-59ecea1f3841
- date added to LUP
- 2016-07-07 06:29:38
- date last changed
- 2024-01-19 06:33:56
@article{3c57db5f-8331-4e64-b032-59ecea1f3841,
abstract = {{<p>The aim was to investigate clinical predictors of adherence to antipsychotics. Medication use was electronically monitored with a Medication Event Monitoring System (MEMS(®)) for 12 months in 112 outpatients with schizophrenia and schizophrenia-like psychosis according to DSM-IV. Symptom burden, insight, psychosocial function (PSP) and side effects were rated at baseline. A comprehensive neuropsychological test battery was administered and a global composite score was calculated. The Drug Attitude Inventory (DAI-10) was filled in. A slightly modified DAI-10 version for informants was distributed as a postal questionnaire. Non-adherence (MEMS(®) adherence ≤0.80) was observed in 27%. In univariate regression models low scores on DAI-10 and DAI-10 informant, higher positive symptom burden, poor function, psychiatric side effects and lack of insight predicted non-adherence. No association was observed with global cognitive function. In multivariate regression models, low patient-rated DAI-10 and PSP scores emerged as predictors of non-adherence. A ROC analysis showed that DAI-10 had a moderate ability to correctly identify non-adherent patients (AUC=0.73, p<0.001). At the most "optimal" cut-off of 4, one-third of the adherent would falsely be identified as non-adherent. A somewhat larger AUC (0.78, p<0.001) was observed when the ROC procedure was applied to the final regression model including DAI-10 and PSP. For the subgroup with informant data, the AUC for the DAI-10 informant version was 0.68 (p=0.021). Non-adherence cannot be properly predicted in the clinical setting on the basis of these instruments alone. The DAI-10 informant questionnaire needs further testing.</p>}},
author = {{Brain, Cecilia and Allerby, Katarina and Sameby, Birgitta and Quinlan, Patrick and Joas, Erik and Karilampi, Ulla and Lindström, Eva and Eberhard, Jonas and Burns, Tom and Waern, Margda}},
issn = {{1873-7862}},
keywords = {{Adult; Aged; Antipsychotic Agents; Area Under Curve; Attitude to Health; Female; Follow-Up Studies; Humans; Male; Medication Adherence; Micro-Electrical-Mechanical Systems; Middle Aged; Neuropsychological Tests; Predictive Value of Tests; Psychiatric Status Rating Scales; Schizophrenia; Schizophrenic Psychology; Surveys and Questionnaires; Sweden; Young Adult}},
language = {{eng}},
number = {{12}},
pages = {{62--1754}},
publisher = {{Elsevier}},
series = {{European Neuropsychopharmacology}},
title = {{Drug attitude and other predictors of medication adherence in schizophrenia : 12 months of electronic monitoring (MEMS(®)) in the Swedish COAST-study}},
url = {{http://dx.doi.org/10.1016/j.euroneuro.2013.09.001}},
doi = {{10.1016/j.euroneuro.2013.09.001}},
volume = {{23}},
year = {{2013}},
}