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Treatment adherence therapy in people with psychotic disorders: randomised controlled trial
A B P Staring1, M Van der Gaag, G T Koopmans
1Erasmus University Medical Center, Department of Psychiatry, Rotterdam, The Netherlands. tonnie@backwash.org
Background:
Interventions to improve adherence to treatment in people with psychotic disorders have produced inconclusive results. We developed a new treatment, treatment adherence therapy (TAT), whose intervention modules are tailored to the reasons for an individual's non-adherence.
Aims:
To examine the effectiveness of TAT with regard to service engagement and medication adherence in out-patients with psychotic disorders who engage poorly.
Method:
Randomised controlled study of TAT v. treatment as usual (TAU) in 109 out-patients. Most outcome measurements were performed by masked assessors. We used intention-to-treat multivariate analyses (Dutch Trial Registry: NTR1159).
Results:
Treatment adherence therapy v. TAU significantly benefited service engagement (Cohen's d = 0.48) and medication adherence (Cohen's d = 0.43). Results remained significant at 6-month follow-up for medication adherence. Near-significant effects were also found regarding involuntary readmissions (1.9% v. 11.8%, P = 0.053). Symptoms and quality of life did not improve.
Conclusions:
Treatment adherence therapy helps improve engagement and adherence, and may prevent involuntary admission.
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