Antipsychotic Adherence Intervention for Veterans over Forty with Schizophrenia: Results of a Pilot Study

This pilot study tested the feasibility, acceptability, and effect sizes of a multimodal, individual intervention designed to optimize antipsychotic medication use in patients ≥40 years of age with schizophrenia or schizoaffective disorder. Methods: We randomized forty patients into two groups: usual care (UC) versus a nine-session, manualized antipsychotic adherence intervention (AAI). The AAI attempted to improve adherence by combining three psychosocial techniques: 1) education; 2) skills training; and, 3) alliance building. Sessions employed a semistructured format to facilitate open communication. The primary outcome was antipsychotic adherence at study end. We obtained qualitative data regarding patient preferences for the duration and modality for receiving the adherence intervention. Results: Compared to the UC group, a greater proportion of the AAI group was adherent post intervention based on medication possession ratio, a commonly used measure of medication adherence (85% vs. 66.6%; OR=2.64), a difference that was statistically not significant. The entire AAI group reported that they intended to take medications, and 75% were satisfied with the intervention. Conclusions: The AAI was feasible and acceptable. Preliminary data on its effectiveness warrant a larger study. Qualitative data show that patients prefer brief adherence interventions and accept telephone strategies.