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Prevention of relapse and interventions for enhancing medication adherence in schizophrenia: An East Asian perspective
Author(s) -
Razali Salleh Mohd
Publication year - 2010
Publication title -
asia‐pacific psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.654
H-Index - 21
eISSN - 1758-5872
pISSN - 1758-5864
DOI - 10.1111/j.1758-5872.2010.00067.x
Subject(s) - psychoeducation , psychological intervention , psychosocial , schizophrenia (object oriented programming) , medicine , intervention (counseling) , psychiatry , relapse prevention , mental illness , clinical psychology , psychology , mental health
Studies investigating the efficacy of interventions for improving treatment non‐adherence in schizophrenia have generated contrasting findings. The present review examined psychosocial interventions for improving medication adherence and prevention of relapse among patients with schizophrenia in developing countries in the Asia‐Pacific. Methods: The relevant literature and systematic review were identified by computerized searches using keywords, and hand‐searched for other selected articles. Results: The reasons for poor medication adherence were complex and heterogenous. Psychoeducation programs alone are ineffective in achieving good medication adherence because they do not lead to attitudinal and behavioral changes. The greatest improvement in adherence was seen with interventions employing a combination of educational, behavioral and cognitive strategies. Unfortunately, few relevant studies from this region were found. There were some interventions related to psychoeducation and compliance therapy (CT) that were successfully conducted by nurses. Patients in developing countries generally had better family support, but strong stigma towards mental illness and interference by traditional healers led to poor treatment adherence. Lack of facilities and shortage of medical professionals aggravated the situation. Discussion: Intervention to improve treatment adherence and prevention of relapse among patients with schizophrenia should be incorporated into existing psychiatric services. Adherence to treatment in patients with schizophrenia could be improved if continuously supported and monitored by caregivers and treating doctors, to facilitate a change in the patient's attitude. Paramedical personnel, such as psychiatric nurses, could be actively involved in intervention programs because of the shortage of medical professionals in this region.