Patient Preference and Adherence (Nov 2019)
Mediating Effect Of The Motivation For Medication Use On Disease Management And Medication Adherence Among Community-Dwelling Patients With Schizophrenia
Abstract
Wen Ling Hsieh,1 Shih Kai Lee,2 Wai Tong Chien,3 Wen I Liu,4 Chien Yu Lai,4 Chieh Yu Liu4 1Department of Nursing, Taipei Municipal Wanfang Hospital (Managed by Taipei Medical University), Taipei City, Taiwan; 2Department of Nursing, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou, Taiwan; 3The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; 4College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, TaiwanCorrespondence: Wen I LiuNational Taipei University of Nursing and Health Sciences, No. 365, Ming-Te Road, Peitou District, Taipei City 11219, TaiwanTel +886 2 2822 7101 Ext. 3184Fax +886 2 2821 3233Email [email protected]: Nearly half of patients with schizophrenia do not adhere to the long-term medical treatment needed to manage their disease. Programs to promote medication adherence include promotion of motivation as a critical element to influence task performance.Purpose: This study investigated the mediating effect of motivation for medication use on disease management and medication adherence in schizophrenia.Methods: This cross-sectional, descriptive correlational study enrolled a convenience sample of 373 community-dwelling patients with schizophrenia in the northern and central regions of Taiwan. Data were collected with questionnaires and a series of validated assessment tools. Hierarchical regression was used to analyze the mediating effect of motivation for medication use on disease management and medication adherence.Results: The medication adherence rate of the patients was 47.2%. The mediating effect of motivation for medication use on therapeutic alliance and medication adherence was 50%, whereas that on insight and medication adherence was 41% and that on medical social support and medication adherence was 72%.Conclusion: Developing a medication motivation care model may be more effective than promoting therapeutic alliance, insight, or medical social support for promoting medication adherence. It also had greater impact on preventing relapses of community-dwelling patients with schizophrenia.Keywords: cross-sectional study, medication adherence, disease management, motivation for medication use, schizophrenia, community-dwelling patients
