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New Screening Tool Can Help Identify Patients Who May Fail to Take Their Medication As Prescribed

Posted on: Tuesday, 22 May 2007, 15:00 CDT

SAN DIEGO, May 22 /PRNewswire/ -- Poor insight, previous failure to take medication and previous discontinuation of medication are the most common reasons for failing to take medication prescribed for schizophrenia in approximately two out of three patients, according to new results from the National Adherence Initiative in Schizophrenia survey, presented today at the 160th Annual Meeting of the American Psychiatric Association.(1)

The survey involved over 13,000 patients with schizophrenia and used a new screening tool, which was developed to help clinicians identify patients with schizophrenia who are at risk of non-adherence with medication.

Non-adherence is when patients fail to take their medication as prescribed by their physician. Previous studies have shown that less than half of patients with schizophrenia prescribed oral antipsychotics take their medication on a regular basis.(2) This is of particular concern as relapse rates are four times higher in patients that do not adhere to their medication.(3) Furthermore, the financial burden of relapse and re- hospitalization in schizophrenia patients in the United States is estimated at approximately $300 million each year.(4)

"It is well known that many patients with schizophrenia fail to take oral antipsychotics as prescribed," said John M. Kane, Lead Investigator and Director, NIMH Intervention Research Center in Schizophrenia, Hillside Hospital, New York. "It is important for physicians to have a brief, simple tool to be able to identify these patients in order to consider interventions or other options, such as long-acting injectable forms of antipsychotics, that can help improve adherence by helping the treatment team know when patients are not taking their medication."

The screening tool was developed by an advisory board of healthcare providers, including psychiatrists, and representatives from advocacy groups. The aim was to develop a brief tool that could be completed by a member of the treatment team to aid in the identification of non-adherence.

The screening tool was assessed in a pilot study involving 134 physicians/clinicians and 309 patients. Based on the pilot results, a final screening tool was developed and administered to 1,522 physicians/clinicians and 13,538 of their patients. The screening tool included eight factors that can be related to non-adherence, including poor insight into illness, forgetting medication, stigma about taking medication, psychotic symptoms, previous discontinuation of medication, recent hospitalization, drug/alcohol abuse, and experiencing side effects.

The most common reasons clinicians gave for non-adherence to medication in their patients were poor insight into illness (74%), previous discontinuation of medication on their own (68%), and forgetting to take medication (67%). There were also significant regional differences identified in all risk factors except 'stigma about taking medication' (p<0.05). Clinicians rated patients in the Western region of the U.S. as having a higher rate of alcohol or other drug abuse compared to the Northeast (47% vs 38%) and higher rate of discontinuing medication on their own compared to the other regions (73% in the West vs 67% in other regions) contributing to non-adherence. Poor insight into illness was rated high in contributing to non-adherence throughout all regions varying from 67% to 70%.

"The screening tool provides useful descriptive data about the key factors contributing to non-adherence of patients to medication regimens and shows that patient's lack of insight into their illness, discontinuation of medication on their own and forgetting to take medication are the most common reasons for non compliance," Dr. Kane said. "It is therefore an important and effective new tool in helping to identify non-adherence and can help clinicians to intervene when appropriate."

The study was sponsored by Janssen, L.P. Janssen is exclusively dedicated to mental health and committed to providing new treatment options and tools for clinicians to help treat patients with psychiatric illnesses.

Janssen, L.P., based in Titusville, N.J., currently markets prescription medications for the treatment of schizophrenia, bipolar mania, and irritability associated with autistic disorder.

For more information about Janssen, L.P., visit http://www.janssen.com/. References (1) Kane JM, Kujawa M, et al. National Adherence Initiative in Schizophrenia: Assessing the risk of partial- and non-adherence in patients with schizophrenia. Presented at the 160th Annual Meeting of the American Psychiatric Association, San Diego, May 23, 2007. Poster board number NR469 (2) Glimer TP, Dolder CR, Lacro JP, et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry 2004; 161:692-699. (3) Prior TI. Avoiding relapse in schizophrenia: Non-compliance and the use of long-acting injectables. Data on file at http://www.janssen-ortho.com/JOI/en/educational/schiz.asp (4) Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Schizophren Bull 1995; 21 (3): 419-429.

Janssen, L.P.

CONTACT: Ambre Morley of Janssen, L.P., +1-609-730-3429

Web site: http://www.janssen.com/http://www.janssen-ortho.com/JOI/en/educational/schiz.asp

Source: PRNewswire

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