Medication Adherence in a Transdiagnostic First-Episode Psychosis Sample

Area of Science:

• Psychiatry
• Clinical Psychology
• Pharmacology

Background:

• Medication adherence significantly impacts treatment outcomes in first-episode psychosis (FEP).
• Understanding predictors of non-adherence is vital for improving patient trajectories.
• Real-world data from FEP clinics are essential for informing clinical practice.

Purpose of the Study:

• To investigate the time to medication non-adherence in a real-world FEP clinic.
• To identify demographic and clinical factors associated with medication non-adherence in FEP patients.

Main Methods:

• Survival analysis was employed using data from 219 patients in an academic psychiatric hospital's FEP clinic (May 2012-Oct 2017).
• The study focused on 122 patients adherent for the initial 6 months, analyzing data up to 66 months.
• Cox proportional hazards models were used to assess predictors of non-adherence.

Main Results:

• Of 122 patients, 30% experienced non-adherence events.
• The risk of non-adherence was 35% at 24 months and 49% at 36 months, plateauing thereafter.
• Significant predictors included non-White race (aHR=3.69), lack of insight (aHR=3.24), and substance use (aHR=2.58).

Conclusions:

• Interventions targeting therapeutic alliance, insight, and substance use are critical for enhancing medication adherence in FEP.
• Addressing these factors may improve long-term outcomes for individuals with first-episode psychosis.
• Clinical strategies should be tailored to mitigate identified risks for non-adherence.