Table 4.
Medication Adherence
| Study | Medications of Interest | Adherence Measurement | Significant improvement in medication adherence* | Medication Adherence Outcome of interest | Medication attitudes | Additional Standardized Scales | Significant Clinical Improvements |
|---|---|---|---|---|---|---|---|
|
| |||||||
| Xu et al., 2019 (42) | Oral psychotropic medication | Pill count, Medication refill, BARS |
Yes | Greater proportion of pills taken by intervention group in non-adherence subgroup (p = 0.047) | DAI-10 | CGI, WHODAS | Reduction in risk of relapse in intervention group, reduction in risk of rehospitalization in intervention group |
| Mohammadi et al., 2016 (43) | Antidepressant medication | Self-report questionnaire | No | No significant difference in depression score or medication adherence (p=0.06 and 0.31) | None | BDI-II-Persian | -- |
| Cullen et al., 2020 (44) | Oral medications (not specified), Long Acting Injectable (LAI) |
Proportion of injections received, BARS | Yes | Oral: Improved medication adherence at 3/6 months (p-0.11). LAI: Significantly higher adherence at 6 months only (p = 0.02) | None | PANSS, RAS-R, MADRS, BUES, YMRS | Positive subset of PANSS lower in intervention group at 6 months; RAS-R recovery scores significantly higher at 3 months in intervention group |
| Beebe et al., 2014 (45) | Oral non-psychiatric medications, Oral and LAI psychotic medication | Pill count, Proportion of injection received |
No | No significant difference in medication adherence for psychiatric or nonpsychiatric medication (p=0.31, p=0.71) | None | BPRS | Significant main effect for group for BPRS scores (mean lower scores on BPRS in TIPS and texting group than TIPS alone or texting alone groups, respectively) |
| Granholm et al., 2012 (46) | Atypical antipsychotics, typical antipsychotics, antidepressants, mood stabilizers |
Self-report: daily ambulatory monitoring outcome assessment question | Yes | Significant improvement in medication adherence in participants living independently (p=0.05) | Self-report | PANSS, BDI-II, ILSS, ANART | Time in the intervention increased the odds of having more social interactions and of reporting less auditory hallucinations |
| Montes et al., 2012 (47) | Oral antipsychotics | MAQ | Yes | Significant reduction in MAQ scores from baseline to 3 months (p=0.02). Maintenance of reduced MAQ score at 6 (p = 0.04) | DAI-10 | CGI-SCH (SI and DC), SUMD, EQ-5D | Reduction in negative symptoms subscale of CGI-SCH-SI, greater improvement in negative, cognitive and global symptom subscales of CGI-SCH-DC at 3 months, improvement in quality of life via EQ-5D in intervention group |
| Menon et al., 2018 (48) | Antipsychotic mood stabilizers |
MMAS | Yes | Significant improvement in medication adherence at baseline to 3 months (p<0.001). Maintenance of improved medication adherence at 6 months for both ITT and completer analyses (p<0.001) | DAI-10 | WHOQOL | -- |
| Levin et al., 2019 (49) | Antipsychotic mood stabilizers Anticonvulsants Anti- hypertensives |
eCAP TRQ |
Yes | Significant decrease from screening to baseline following 2 months of intervention for both Bipolar Disorder and HTN medication adherence (p<0.001). No significant decrease between any time points for eCAP. | None | BPRS, MADRS, YMRS, SRHI | Decreased systolic blood pressure, improved BPRS scores, and lower MADRS scores, and higher habit formation between screening and follow-up time points during intervention |
| Moore et al., 2015 (50) | Psychotropics antiretrovirals |
eCAP self-report visual analogue scale |
No | No significant difference in adherence to psych or antiretroviral medications | None | YMRS, BDI-II | -- |
| Cai et al., 2020 (51)† | -- | -- | Yes | Greater proportion of pills taken during extended intervention period (p = 0.004) | -- | -- | Decrease in illness severity via CGI reduction in hospitalizations during intervention periods compared to control period |
For at least one analysis related to medication adherence
Represents an extension of Xu et al., 2019; blank columns remained the same across the two
Abbreviation Guide for Table4:
Clinical Global Impression (CGI)
Clinical Global Impression-Schizophrenia Scale, severity of illness and degree of change (CGI-SCH, SI and DC)
Morisky Green Adherence Questionnaire (MAQ)
WHO Disability Assessment Schedule 2.0 (WHODAS)
WHO Quality of Life Instrument (WHOQOL)
Positive and Negative Syndrome Scale (PANSS)
Beck Depression Inventory-II-Persian (BDI-II-Persian)
The Montgomery- Asberg Depression Rating Scale (MADRS)
Recovery Assessment Scale Revised (RAS-R)
Brief Adherence Rating Scale (BARS)
Boston University Empowerment Scale (BUES)
Brief Psychiatric Rating Scale (BPRS)
Independent Living Skills Survey (ILSS)
American National Adult Reading Test (ANART)
Drug Attitude Inventory-10 (DAI-10)
Morisky Medication Adherence Scale (MMAS)
Tablets Routine Questionnaire (TRQ)
Self-Report Habit Index (SRHI)