Psychiatrists' awareness of partialand non-adherence to antipsychotic medication in schizophrenia: Results from the Australian ADHES survey

Objectives: The Adherence in Schizophrenia (ADHES) initiative aimed to assess physicians' perspectives about treatment adherence in people with schizophrenia, and assess strategies to improve adherence. Methods: Between March and April 2012, a 20-question survey was delivered to Australian psychiatrists (n = 3400). These anonymous surveys were returned by mail. The survey asked about the demographics of participating psychiatrists and the respondents' perceptions of different factors that affect the adherence of people with schizophrenia to their treatment with antipsychotic medications. Adherence was defined by the proportion of prescribed doses taken: non-adherence, if < 30%; partial-adherence, 30%-90%; and adherent, > 90%. Data were reported descriptively and were not weighted. Results: Respondent psychiatrists (n = 406; response rate 12%) reported that one-half (51%) of people with schizophrenia were either non-adherent (20%) or only partially adherent (31%). This was despite most (72%) psychiatrists' reporting that they assessed adherence to medication at every visit. The main reported reasons for medication discontinuation were: lack of insight (45%), drug or alcohol abuse (3%), or side effects (29%). The preferred strategies for improving adherence were switching to or adding a long-acting antipsychotic (40%), or simplifying the medication regimen (30%). Conclusions: Lack of adherence to antipsychotic medication remains a problem. More proactive management is required, to improve adherence and long-term outcomes.