Effects of Adherence Therapy on Improving Medication Adherence and Clinical Outcomes in Patients with Psychosis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 HEMei ¹ ,  YANGBing-xiang ² , CHENXiao-li ²

1. Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China;
2. HOPE School of Nursing, Wuhan University, Wuhan 430071, China;

Corresponding author：

YANGBing-xiang, Email: yangbx2012@qq.com

Keywords：

Adherence therapy; Psychosis; Medication adherence; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160030

Video：

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Objective To systematically review the effects of adherence therapy in improving medication adherence and clinical outcomes in psychosis patients. Methods We searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2015), EBSCO, CBM, CNKI, VIP, and WanFang Data from inception to Oct. 2015, to collect randomized controlled trials (RCTs) about adherence therapy for patients with psychosis. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 13 RCTs involving 1 244 patients were included. The results of metaanalysis showed that adherence therapy could improve attitude towards medication adherence (MD=3.12, 95%CI 1.26 to 4.98, P=0.001), behavioral adherence (SMD=0.54, 95%CI 0.21 to 0.88, P=0.001), function (SMD=0.42, 95%CI 0.28 to 0.56, P=0.000 01) and insight of diseases (SMD=0.34, 95%CI 0.15 to 0.54, P=0.000 7) in patients with psychosis. But regarding psychotic symptoms, hospital stay, medical costs and adverse drug reactions, adherence therapy did not show benefit (all P values >0.05). Conclusion Current evidence shows that adherence therapy could improve medication adherence, function and insight towards diseases in patients with psychosis. Due to the limited quantity and quality of included studies, more large-scale, multi-center, and high quality RCTs are needed to verify the above conclusion.

Citation： HEMei, YANGBing-xiang, CHENXiao-li. Effects of Adherence Therapy on Improving Medication Adherence and Clinical Outcomes in Patients with Psychosis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2016, 16(2): 183-190. doi: 10.7507/1672-2531.20160030 Copy

1.	赵维敏, 李明芳. 住院精神病病患者药物治疗依从性的影响因素及护理对策. 齐齐哈尔医学院学报, 2012, 33(1):105-106.
2.	Chien W, Leung S. A controlled trial of a needs-based, nurse-led psychoeducation programme for Chinese patients with first-onset mental disorders:6 month follow up. Int J Nurs Pract, 2013, 19(1): 3-13.
3.	Chien WT, Chan SW, Thompson DR. Effects of a mutual support group for families of Chinese people with schizophrenia:18-month follow-up. Br J Psychiatry, 2006, 189(1):41-49.
4.	Gray R, Wykes T, Gournay K. From compliance to concordance:a review of the literature on interventions to enhance compliance with antipsychotic medication. J Psychiatr Ment Health Nurs, 2002, 9(3): 277-284.
5.	张跃兰, 邢改书, 张润兰, 等. 循证护理对住院精神分裂症患者依从性的影响研究. 中国循证医学杂志, 2007, 7(12):862-865.
6.	Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics:reliability and discriminative validity. Psychol Med, 1983, 13(1):177-183.
7.	王金海,张星华,杜小正, 等. 头针治疗缺血性卒中疗效的Meta 分析. 中国循证医学杂志, 2015, 15(10):1161-1167.
8.	Anderson KH, Ford S, Robson D, et al. An exploratory, randomized controlled trial of adherence therapy for people with schizophrenia. Int J Ment Health Nurs, 2010, 19(5):340-349.
9.	von Bormann S, Robson D, Gray R. Adherence therapy following acute exacerbation of schizophrenia:A randomised controlled trial in Thailand. Int J Soc Psychiatry, 2015, 61(1):3-9.
10.	Cavezza C, Aurora M, Ogloff, JR. The effects of an adherence therapy approach in a secure forensic hospital:a randomised controlled trial. J Forens Psychiatry Psychol, 2013, 24(4), 458-478.
11.	Chien WT, Mui JH, Cheung EF, et al. Effects of motivational interviewing-based adherence therapy for schizophrenia spectrum disorders:a randomized controlled trial. Trials, 2015, 16(1):270-284.
12.	Gilden J, Staring ABP, der Gaag MV, et al. Does treatment adherence therapy reduce expense of healthcare use in patients with psychotic disorders? Cost-minimization analysis in a randomized controlled trial. Schizophrenia Res, 2011, 133(1-3):47-53.
13.	Gray R, Leese M, Bindman J, et al. Adherence therapy for people with schizophrenia. European multicentre randomised controlled trial. Br J Psychiatry, 2006, 189(6):508-514.
14.	Kemp R, Hayward P, Applewhaite G, et al. Compliance therapy in psychotic patients:randomised controlled trial. BMJ, 1996, 312(7027):345-349.
15.	Kemp R, Kirov G, Everitt B, et al. Randomised controlled trial of compliance therapy. 18-month follow-up. Br J Psychiatry, 1998, 172(5):413-419.
16.	Maneesakorn S, Robson D, Gournay K, et al. An RCT of adherence therapy for people with schizophrenia in Chiang Mai, Thailand. J Clin Nurs, 2007, 16(7):1072748081.
17.	O'Donnell C, Donohoe G, Sharkey L, et al. Compliance therapy:a randomised controlled trial in schizophrenia. BMJ, 2003, 327(7419): 834-838.
18.	Patel A, Mccrone P, Leese M, et al. Cost-effectiveness of adherence therapy versus health education for people with schizophrenia: randomised controlled trial in four European countries. Cost Eff Resour Alloc, 2013, 11(1):12-25.
19.	Schulz M, Gray R, Spiekermann A, et al. Adherence therapy following an acute episode of schizophrenia:A multi-centre randomised controlled trial. Schizophr Res, 2013, 146(1-3):59-63.
20.	Staring ABP, Van der Gaag M, Koopmans GT, et al. Treatment adherence therapy in people with psychotic disorders:randomised controlled trial. Br J Psychiatry, 2010, 197(6):448-455.
21.	Brown E, Gray R, Jones M, et al. Effectiveness of adherence therapy in patients with early psychosis:a mirror image study. Int J Ment Health Nurs, 2013, 22(1):24-34.
22.	Gray R, White J, Schulz M, et al. Enhancing medication adherence in people with schizophrenia:An international programme of research. Int J Ment Health Nurs, 2010, 19(1):36-44.
23.	Puschner B, Born A, Giessler A, et al. Adherence to medication and quality of life in people with schizophrenia:results of a European multicenter study. J Nerv Ment Dis, 2006, 194(10):746-752.
24.	Caplan, G. (1964). Principles of preventive psychiatry. New York, NY:Basic Books.

1. 赵维敏, 李明芳. 住院精神病病患者药物治疗依从性的影响因素及护理对策. 齐齐哈尔医学院学报, 2012, 33(1):105-106.
2. Chien W, Leung S. A controlled trial of a needs-based, nurse-led psychoeducation programme for Chinese patients with first-onset mental disorders:6 month follow up. Int J Nurs Pract, 2013, 19(1): 3-13.
3. Chien WT, Chan SW, Thompson DR. Effects of a mutual support group for families of Chinese people with schizophrenia:18-month follow-up. Br J Psychiatry, 2006, 189(1):41-49.
4. Gray R, Wykes T, Gournay K. From compliance to concordance:a review of the literature on interventions to enhance compliance with antipsychotic medication. J Psychiatr Ment Health Nurs, 2002, 9(3): 277-284.
5. 张跃兰, 邢改书, 张润兰, 等. 循证护理对住院精神分裂症患者依从性的影响研究. 中国循证医学杂志, 2007, 7(12):862-865.
6. Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics:reliability and discriminative validity. Psychol Med, 1983, 13(1):177-183.
7. 王金海,张星华,杜小正, 等. 头针治疗缺血性卒中疗效的Meta 分析. 中国循证医学杂志, 2015, 15(10):1161-1167.
8. Anderson KH, Ford S, Robson D, et al. An exploratory, randomized controlled trial of adherence therapy for people with schizophrenia. Int J Ment Health Nurs, 2010, 19(5):340-349.
9. von Bormann S, Robson D, Gray R. Adherence therapy following acute exacerbation of schizophrenia:A randomised controlled trial in Thailand. Int J Soc Psychiatry, 2015, 61(1):3-9.
10. Cavezza C, Aurora M, Ogloff, JR. The effects of an adherence therapy approach in a secure forensic hospital:a randomised controlled trial. J Forens Psychiatry Psychol, 2013, 24(4), 458-478.
11. Chien WT, Mui JH, Cheung EF, et al. Effects of motivational interviewing-based adherence therapy for schizophrenia spectrum disorders:a randomized controlled trial. Trials, 2015, 16(1):270-284.
12. Gilden J, Staring ABP, der Gaag MV, et al. Does treatment adherence therapy reduce expense of healthcare use in patients with psychotic disorders? Cost-minimization analysis in a randomized controlled trial. Schizophrenia Res, 2011, 133(1-3):47-53.
13. Gray R, Leese M, Bindman J, et al. Adherence therapy for people with schizophrenia. European multicentre randomised controlled trial. Br J Psychiatry, 2006, 189(6):508-514.
14. Kemp R, Hayward P, Applewhaite G, et al. Compliance therapy in psychotic patients:randomised controlled trial. BMJ, 1996, 312(7027):345-349.
15. Kemp R, Kirov G, Everitt B, et al. Randomised controlled trial of compliance therapy. 18-month follow-up. Br J Psychiatry, 1998, 172(5):413-419.
16. Maneesakorn S, Robson D, Gournay K, et al. An RCT of adherence therapy for people with schizophrenia in Chiang Mai, Thailand. J Clin Nurs, 2007, 16(7):1072748081.
17. O'Donnell C, Donohoe G, Sharkey L, et al. Compliance therapy:a randomised controlled trial in schizophrenia. BMJ, 2003, 327(7419): 834-838.
18. Patel A, Mccrone P, Leese M, et al. Cost-effectiveness of adherence therapy versus health education for people with schizophrenia: randomised controlled trial in four European countries. Cost Eff Resour Alloc, 2013, 11(1):12-25.
19. Schulz M, Gray R, Spiekermann A, et al. Adherence therapy following an acute episode of schizophrenia:A multi-centre randomised controlled trial. Schizophr Res, 2013, 146(1-3):59-63.
20. Staring ABP, Van der Gaag M, Koopmans GT, et al. Treatment adherence therapy in people with psychotic disorders:randomised controlled trial. Br J Psychiatry, 2010, 197(6):448-455.
21. Brown E, Gray R, Jones M, et al. Effectiveness of adherence therapy in patients with early psychosis:a mirror image study. Int J Ment Health Nurs, 2013, 22(1):24-34.
22. Gray R, White J, Schulz M, et al. Enhancing medication adherence in people with schizophrenia:An international programme of research. Int J Ment Health Nurs, 2010, 19(1):36-44.
23. Puschner B, Born A, Giessler A, et al. Adherence to medication and quality of life in people with schizophrenia:results of a European multicenter study. J Nerv Ment Dis, 2006, 194(10):746-752.
24. Caplan, G. (1964). Principles of preventive psychiatry. New York, NY:Basic Books.

Chinese Journal of Evidence-Based Medicine

Effects of Adherence Therapy on Improving Medication Adherence and Clinical Outcomes in Patients with Psychosis: A Systematic Review

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