Effectiveness of Adherence Therapy for Schizophrenia

An Evaluation of the Effectiveness of Adherence Therapy for Schizophrenia: A Randomized Controlled Trial

When compared with those in the control (usual care) group, participants in the AT group are expected to demonstrate significant improvements immediately and at three, six and 12 months after completion of the intervention in: level of medication adherence, readmission rate, mental status, insight into treatment, and level of functioning.

When compared with those in the control (usual care) group, participants in the AT group are expected to demonstrate significant improvements immediately and at three, six and 12 months after completion of the intervention in the following aspects:

1. level of adherence to antipsychotic medication,
2. rate and length of psychiatric hospital readmission,
3. mental status,
4. insight and attitude into illness and treatment, and
5. level of functioning.

The primary outcomes are level of antipsychotic medication adherence, re-hospitalization rates and mental status; and the patients' drug attitude will be the mediating factor of the AT.

Inclusion Criteria of the patients include those who:

• are Hong Kong Chinese residents;
• have a primary diagnosis of schizophrenia or its subtypes such as schizophreniform and schizoaffective disorders not more than 3 years;
• have been prescribed oral antipsychotics for at least 1 month;
• are aged 18-65 years;
• have Positive and Negative Syndrome Scale (PANSS) score >60 and are judged by the case Community Psychiatric Nurse/psychiatrist as non-adherents; and
• are able to understand Cantonese/Mandarin.

Patients will be excluded if they have:

• only depot/intramuscular injections as regular psychiatric medication;
• co-morbidity of learning disability and organic brain disease, or clinically significant medical diseases;
• participated in adherence therapy; and/or
• visual, language or communication difficulty.