Background/Aim. There is a high rate of schizophrenic patients who do not
adhere to their prescribed therapy, despite the implementation of
antipsychotic long-acting injections and the introduction of atypical
antipsychotics. The aim of this study was to investigate the differences in
sociodemographic, clinical and medication adherence variables between the two
groups of schizophrenic patients on maintenance therapy with depot
antipsychotic fluphenazine decanoate and oral antipsychotics only as well as
a correlation between the medication adherence and other examined variables.
Methods. A total of 56 patients of both genders, aged < 60 years, with the
diagnosis of schizophrenia (F20) (ICD-10, 1992) clinically stable for at
least 6 months were introduced in this cross-sectional study. The patients
from the depot group (n = 19) were on classical depot antipsychotic
fluphenazine decanoate administering intramuscularly every 4 weeks (with or
without oral antipsychotic augmentation) and the patients from the oral group
(n = 37) were on oral therapy alone with classical or atypical
antipsychotics, either as monotherapy or combined. The Positive and Negative
Syndrome Scale (PANSS) was used to assess symptom severity. Item G12 of the
PANSS was used to assess insight into the illness. The patients completed the
Medical Adherence Rating Scale (MARS) was used to assess adherence to the
therapy. A higher MARS score indicates behavior [Medical Adherence
Questionnaire (MAQ subscale)] and attitudes toward medication [Drug Attitude
Inventory (DAI subscale)] that are more consistent with treatment adherence.
The exclusion criteria were determined. The Pearson's ?2 test was used to
compare categorical variables, Student's t-test to compare continuous
variables and Pearson's correlation to test the correlation significance; p =
0.05. Results. Significant betweengroup differences in age, illness duration,
chlorpromazine equivalents, PANSS score and DAI subscore were found. Item G12
of the PANSS subscore and MARS score correlated significantly negatively. A
significant positive correlation between receiving depot antipsychotic and
DAI subscore as well as between illness duration and both DAI subscore and
MARS score were also found. Conclusion. Schizophrenic patients on classical
depot antipsychotic maintenance therapy might present subpopulation of
patients with significantly longer illness duration, more favorable
medication attitude and outcome in relation to those on oral antipsychotics
alone.
Adherence to depot versus oral antipsychotic medication in schizophrenic patients during the long-term therapy