scholarly journals Adherence to depot versus oral antipsychotic medication in schizophrenic patients during the long-term therapy

2013 ◽  
Vol 70 (3) ◽  
pp. 267-273 ◽  
Author(s):  
Zana Stankovic ◽  
Tatjana Ille
Keyword(s):  
Medication Adherence ◽  
Maintenance Therapy ◽  
Atypical Antipsychotics ◽  
Categorical Variables ◽  
Medical Adherence ◽  
Fluphenazine Decanoate ◽  
Illness Duration ◽  
Depot Antipsychotic ◽  
Schizophrenic Patients ◽  
Oral Antipsychotic

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.

Observations on the Dose Regime of Fluphenazine Decanoate in Maintenance Therapy of Schizophrenia

1975 ◽  
Vol 126 (5) ◽  
pp. 457-461 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
Side Effects ◽  
Maintenance Therapy ◽  
Clinical Importance ◽  
Fluphenazine Decanoate ◽  
Dose Regime ◽  
Schizophrenic Patients

SummaryAn analysis of the drug regimes prescribed to two separate groups of unselected schizophrenic patients indicates certain trends of clinical importance. The results demonstrate a need for the adoption of a personalized dose regime. The scatter of dose regimes found effective is too great to recommend a standardized approach to the prescription of L.A.P. injections.Two other results of particular significance are that the dose of drug required to control symptoms can be gradually reduced in nearly half of patients, and that helpful trends in prescribing were identified that will help the clinician to abolish side-effects.

Indication of depot antipsychotic treatment in the view of slovak psychiatrists

2016 ◽  
Vol 33 (S1) ◽  
pp. S553-S553
Author(s):  
M. Zelman
Keyword(s):  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Young Patients ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Depot Antipsychotic ◽  
Treatment Research ◽  
Competing Interest ◽  
Oral Antipsychotic ◽  
Depot Form

With the increasing number of atypical antipsychotics in depot form, there emerges question about plus and cons of their use in schizophrenia patients. We focused on the opinion of Slovak psychiatrists about use of this treatment in some specific situations of schizophrenia treatment. Research was realized via questionnaire on psychiatrists (n = 47) from ambulant and hospital care, during one conference in June 2015. First part of the questionnaire was focused on the preference of oral or depot form of antipsychotic treatment. Depot form would be indicated by psychiatrists (in more than 89%) when low compliance, anosognosia or frequent episodes. On the contrary, oral antipsychotic treatment is preferred in young patients or employed patients. The type of symptoms (e.g. positive, negative) has relatively small impact on the preference of treatment, where the preferences of each type were the lowest (fewer than 36%). According to the opinion of psychiatrists, depot antipsychotic treatment is not suitable in first episode of disorder (according to 81% of respondents), otherwise in second or third episode it would not be chosen by 6% of asked psychiatrists.From the aspects of the choice between atypical or typical depot, atypical antipsychotics in depot form were favored when presence of adverse reactions (80%), occurrence of negative symptoms (65%) and short duration of disorder (58%). Typical depot was preferred by psychiatrists in patients with chronic states.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evaluation of Inpatient Depot Antipsychotic Prescribing

1996 ◽  
Vol 30 (12) ◽  
pp. 1381-1386 ◽  
Author(s):  
Dennis J Pabis ◽  
Peter G Dorson ◽  
M Lynn Crismon
Keyword(s):  
Length Of Stay ◽  
Product Information ◽  
Length Of Hospital Stay ◽  
Inpatient Setting ◽  
Pharmacy Staff ◽  
Antipsychotic Therapy ◽  
Fluphenazine Decanoate ◽  
Short Acting ◽  
Depot Antipsychotic ◽  
Depot Therapy

OBJECTIVE: To assess the use of fluphenazine decanoate and haloperidol decanoate in an inpatient setting. DESIGN: A prospective observational study conducted over a 3-month period. SETTING: A 400-bed state psychiatric hospital. INTERVENTIONS: The psychiatric pharmacy staff evaluated the medical records and new orders of 30 consecutive patients receiving depot antipsychotic formulations using a detailed evaluation form and the hospital pharmacy computer database. Criteria for evaluation were derived from the medical literature and product information, and included the following areas: diagnosis, stabilization on a short-acting form of the antipsychotic, appropriateness of dosage conversion to depot therapy, concomitant administration of short-acting antipsychotics (and duration of concomitant medications), and plasma concentration monitoring. RESULTS: Only 7 patients (23%) received what would be considered optimal depot antipsychotic therapy. These patients were receiving a stable dosage of a short-acting antipsychotic prior to conversion to depot therapy (i.e., ≥7 d), received optimal dose conversion to a depot form, and received optimum overlap with a short-acting preparation (i.e., overlap ≤7 d with fluphenazine HCl and 7–30 d with haloperidol HCl). When length of stay data were evaluated, no significant differences were observed in patients who received optimal therapy versus those who did not. There was also no difference in length of stay when the study group was compared with an age-, sex-, and diagnosis-matched cohort group. However, quantitatively fewer adverse effects were reported for patients whose treatment was considered optimal on the basis of the evaluation criteria. CONCLUSIONS: Depot antipsychotic therapy frequently did not meet the criteria for optimal use. This did not affect length of hospital stay in these individuals. However, individuals who met the criteria experienced quantitatively fewer adverse events.

Blonanserin augmentation in patients with schizophrenia – who is benefited from blonanserin augmentation?: An open-label, prospective, multicenter study

2016 ◽  
Vol 33 (S1) ◽  
pp. s226-s226
Author(s):  
Y.S. Woo ◽  
J.E. Park ◽  
D.H. Kim ◽  
I.K. Sohn ◽  
T.Y. Hwang ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Atypical Antipsychotics ◽  
Therapeutic Strategy ◽  
Psychiatric Symptoms ◽  
Open Label ◽  
Prospective Multicenter Study ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Competing Interest ◽  
Negative Syndrome

IntroductionEvidences for antipsychotics augmentation for schizophrenic patients with suboptimal efficacy have been lacking although it has been widespread therapeutic strategy in clinical practice.ObjectivesThe purpose of this study was to investigate the efficacy and tolerability of blonanserin augmentation with an atypical antipsychotics (AAPs) in schizophrenic patients.MethodsA total of 100 patients with schizophrenia partially or completely unresponsive to treatment with an AAP recruited in this 12-week, open-label, non-comparative, multicenter study. Blonanserin was added to existing AAPs which were maintained during the study period. Efficacy was primarily evaluated using Positive and Negative Syndrome Scale (PANSS) at baseline, week 2, 4, 8, and 12. Predictors for PANSS response (≥ 20% reduction) was investigated.ResultsThe PANSS total score was significantly decreased at 12 weeks after blonanserin augmentation (–21.0 ± 18.1, F = 105.849, P < 0.001). Response rate on PANSS at week 12 was 51.0%. Premature discontinuation was occurred in 17 patients (17.0%) and 4 patients among them discontinued the study due to adverse events. Nine patients experienced significant weight gain during the study. Response to blonanserin augmentation was associated with severe (PANSS > 85) baseline symptom (OR = 10.298, P = 0.007) and higher dose (> 600 mg/day of chlorpromazine equivalent dose) of existing AAPs (OR = 4.594, P = 0.014).ConclusionsBlonanserin augmentation improved psychiatric symptoms of schizophrenic patients in cases of partial or non-responsive to an AAP treatment with favorable tolerability. Patients with severe symptom despite treatment with higher dose of AAP were benefited from this augmentation. These results suggested that blonanserin augmentation could be an effective strategy for specific patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Support of medication adherence by community pharmacists in Czech and Slovak Republics: a questionnaire survey study

2018 ◽  
Vol 65 (1) ◽  
pp. 15-23 ◽  
Author(s):  
M. Molitorisová ◽  
J. Kotlářová ◽  
M. Snopková ◽  
I. Waczulíková
Keyword(s):  
Medication Adherence ◽  
Questionnaire Survey ◽  
Information Technologies ◽  
Real Life ◽  
Community Pharmacists ◽  
Survey Study ◽  
Categorical Variables ◽  
Average Score ◽  
Technical Equipment ◽  
Adherence Support

Abstract Introduction: Intervention of pharmacists in medication adherence can meaningfully contribute to achieving therapeutic outcomes. Exploring the real-life readiness and opportunities of pharmacists may result in the adoption of measures, which could be seen through improvement of patients’ adherence to pharmacotherapy. Aim: The aim of the paper was to make a survey on community pharmacists’ potential in medication adherence support in its connectivity to technical and personnel factors, which underline the capacities of pharmacies in dealing with medication adherence. Methods: The questionnaire survey was conducted from October to December 2014 and involved 158 pharmacists from 117 Czech (CZ) and 41 Slovak (SK) community pharmacies. The structured questionnaire surveyed both technical and personnel factors, including provision of consultancy services related to medication adherence. Non-adherence risk reduction was evaluated by adopting Morisky Scale modified from the pharmacist’s perspective. Questionnaires outcomes were summarised in contingency tables and analyzed for associations between respective categorical variables using χ2 or exact tests and association coefficients. All results are reported as significant at P≤0.05. Results: The average score of adherence support (CZ/SK 1.95/1.93) was significantly higher as compared to that of persistence or concordance (P<0.001). Reduction of non-adherence risk reached the score of a medium degree (P=0.73, average 2.29 in CZ and 2.22 in SK). These findings were significantly associated with personnel capacities (provision of consultancy, preference for the use of recommended procedures in CZ (P<0.001), number of years of practice in SK (P=0.029)), while significant association with technical equipment (consultancy room) in the SK (P=0.037). Conclusion: The pharmaceutical care is developing towards the improvement of medication adherence in both countries - assuming a medium degree of adherence support. Further progress may be observed in strengthening the pharmacists’ personnel capacities, and accelerated mainly using information technologies, i.e. through technical capacities.

LC–MS/MS assay for assessing medical adherence in patients under warfarin maintenance therapy

2018 ◽  
Vol 141 ◽  
pp. 135-140 ◽  
Author(s):  
Faten Farouk ◽  
Samir Nabhan ◽  
Wilfried M.A. Niessen ◽  
Hassan M.E. Azzazy
Keyword(s):  
Maintenance Therapy ◽  
Medical Adherence

The Expectation of Outcome from Maintenance Therapy in Chronic Schizophrenic Patients

1976 ◽  
Vol 128 (3) ◽  
pp. 246-250 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
Maintenance Therapy ◽  
Patient Population ◽  
Significant Proportion ◽  
Community Services ◽  
Neuroleptic Drugs ◽  
Follow Up Study ◽  
High Incidence ◽  
Schizophrenic Patients ◽  
Long Acting

SummaryThe results from a prospective follow-up study of a group of schizophrenic patients suggest that a significant proportion (41 per cent) are likely to relapse during a two-year period despite the prescription of long-acting injectable neuroleptic drugs. Some will relapse because of a failure of the regime, but others (32–37 per cent) because the pharmacological protection of these drugs would appear to be less effective in certain patients. Even with the major advantages of the long-acting injectable neuroleptics over oral medication, the schizophrenic patient population remains a group with a high incidence of psychiatric and social morbidity which continues to require the full resources of both the hospital and community services.

scholarly journals Barriers to Medication Adherence among Hypertensive Patients in Deprived Rural Areas

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Ebrahim Aliafsari Mamaghani ◽  
Edris Hasanpoor ◽  
Esmaiel Maghsoodi ◽  
Farzaneh Soleimani
Keyword(s):  
Medication Adherence ◽  
Rural Communities ◽  
Negative Correlation ◽  
Rural Areas ◽  
Medical Adherence ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Positive Correlation ◽  
Adherence To Medication

BACKGROUND: Poor adherence to medication regimen leads to poor health outcomes, increased medical costs and increased death rate due to hypertension. The aim of this study was to evaluate baseline barriers to medication adherence among hypertensive patients in deprived rural areas.METHODS: A cross-sectional study was conducted on 238 hypertensive patients living in deprived rural areas of Iran. Data were collected using a questionnaire consisting of demographic information, Morisky medication adherence scale and the barriers to medication adherence that were reliable and valid.RESULTS: The results of the study showed that medication adherence was significantly decreased and had a significant positive correlation with gender and economic status, while it had a negative correlation with age. Medication Adherence had a positive correlation with the duration of hypertension, while it had a negative correlation with the number of medications used and concurrently with other diseases.CONCLUSIONS: Based on the present study it can be concluded that enhanced knowledge about illness and treatment in rural communities is improves the medical adherence. Financial supports along with the reduced number of prescribed drugs are also found to be the determining factors in the medical adherence. 

scholarly journals Circulating IGFBP-2 levels reveal atherogenic metabolic risk in schizophrenic patients using atypical antipsychotics

2020 ◽  
pp. 1-8
Author(s):  
Marc-André Nolin ◽  
Marie-France Demers ◽  
Chloé Rauzier ◽  
Roch-Hugo Bouchard ◽  
Camille Cadrin ◽  
...  
Keyword(s):  
Atypical Antipsychotics ◽  
Metabolic Risk ◽  
Schizophrenic Patients
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