Skills-based medication training program for patients with schizophrenic disorders: a rater-blind randomized controlled trial

Abstract

Uwe B Schirmer,1 Tilman Steinert,1,2 Erich Flammer,1,2 Raoul Borbé1,2 1Centre for Psychiatry South-Wuerttemberg, Ravensburg, Germany; 2Ulm University, Department Psychiatry I, Ravensburg, Germany Background: The long-term course of schizophrenia is often characterized by relapses, induced by poor medication adherence. Early nonadherence after discharge is frequent. Objective: To evaluate a skills-based inpatient training program for medication intake. Methods: We developed a manual-based inpatient medication training program to be carried out by nurses and focusing on practical skills enabling autonomous intake of medication. Medication adherence was measured by three different methods: pill count, determination of serum levels, and self-assessment by the patient. The raters were blinded. Results: Four weeks after discharge, 98% of the patients in the intervention group (N=52) were rated as adherent by pill count versus 76% in the control group (N=50; P<0.01). By measurement of serum level, 88.5% versus 70% were adherent (P<0.05). Conclusion: The inpatient medication training program carried out by nurses seems to be an effective intervention for enhancing medication adherence after hospital discharge. Keywords: adherence, psychopharmacotherapy, schizophrenia