Improving Treatment Adherence in Schizophrenia

Opinion statement Poor treatment adherence among people with schizophrenia is associated with several negative outcomes, including increased risk of symptom relapse, persistent psychotic symptoms, frequent hospitalizations, increased emergency room use, and suicide attempts. In addition, the benefits of treatment adherence in this population include improved quality of life and reduced treatment costs. Clearly, feasible and effective strategies to maximize treatment adherence are essential. Interventions to promote adherence to medications include environmental cues and supports, technology-based interventions, medication management coordinators, adherence therapy, and the use of long-acting injectable medications. Interventions to promote continuity of care between inpatient and outpatient treatment include Assertive Community Treatment, transitional care models, and the use of peer support personnel as care navigators. Transitional care models have also demonstrated effectiveness in promoting adherence to primary care follow-up among people with schizophrenia and comorbid medical illnesses. In the context of complex treatment regimens for psychiatric and medical illnesses, thorough education and skill development on illness management and health promotion, tailored to the unique learning needs of PWS, are essential. In addition, more research is needed to address understanding of medical illnesses, the accuracy in which people with schizophrenia implement activities for medical illness self-management, and development of strategies to promote engagement in health promotion activities among people with schizophrenia.