Strategies That Improve Treatment Adherence

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Cognitive-behavioral therapy (CBT) is effective in enhancing treatment adherence. CBT doesn’t challenge a patient’s resistance to medication; instead it explores why the person doesn’t want to take medication and helps them reevaluate their negative beliefs toward medication.

Also, CBT helps patients identify their recovery goals, and links them to treatment adherence, according to Velligan. For instance, many people with schizophrenia take their medication because of relationships, whether it’s a relationship with their spouse or family member. For these individuals, one goal may address relationship quality.

CBT incorporates motivational interviewing techniques and helps patients see a clear link between poor adherence and relapse. (Thisfull-text article provides more information on CBT for schizophrenia.)

Visual reminders, such as signs, checklists and pill containers, facilitate adherence. Velligan and her colleagues have even used electronic pill containers to prompt patients and provide a slew of important information: “to tell patients when to take medication, remind the person of the dose and reason for medication, tell the person if they are taking the wrong medication or taking it at the wrong time, and download adherence data to a secure server so that a caregiver or caseworker can keep track of adherence are becoming more widely available.”

Another option is injectable medication. Several studies have shown that long-term injectable antipsychotics increase adherence and decrease relapse risk. (Learn more here and here.) “If a person does not show up for an injection, the treatment team knows there is an issue and can intervene in a timely way,” Velligan said. Otherresearch has suggested that it’s also important to discuss the benefits of adherence with patients receiving injectable medication.

By MARGARITA TARTAKOVSKY, M.S.

http://psychcentral.com/lib/2012/increasing-treatment-adherence-in-schizophrenia/

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