By Emilio Sacchetti, Antonio Vita, Alberto Siracusano, Wolfgang Fleischhacker
Poor adherence to remedy is likely one of the major hindrances to therapy effectiveness in schizophrenia. it's the major determinant of relapse, hospitalization, symptom endurance, and terrible psychosocial functioning and consequence. Adherence to remedy is plagued by different factors with regards to the sickness features, to the sufferer him- or herself, to the remedy, and to the healing dating. a few of these components are modifiable, and either pharmacological and non-pharmacological recommendations were built for this objective. This ebook addresses different features of adherence to therapy in schizophrenia and comparable issues in a scientific yet easy-to-use guide structure. Chapters specialise in an entire variety of matters, together with pharmacological and non-pharmacological options to reinforce adherence and continuity of care, proper mental components, the significance of the patient-doctor courting, and the necessity for an alliance with different care-givers. Adherence to Antipsychotics in Schizophrenia should be a useful asset for all who're interested in the care of sufferers with schizophrenia.
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Additional info for Adherence to Antipsychotics in Schizophrenia
57 for a second relapse in the group of subjects who, after an initial relapse, were prescribed to continue antipsychotic medication for the remainder of the trial. Although preferentially supported by studies of patients with first-episode schizophrenia, the negative influence of poor adherence to antipsychotic medication on relapse risk is a phenomenon that is commonly present at all stages of the disorder. 7 times greater than patients rated as compliant’’. 79 for relapses in patients presenting a non-adherence status.
Because stigma is a dynamic condition that can be controlled with dedicated interventions, numerous international, national and local campaigns on destigmatisation have taken place in recent years. In general, the programmes have been based on the hypothesis that improved knowledge on the biological foundation of schizophrenia should promote assimilation of the disorder with any other brain disease and thus improve medication adherence. Despite some experimental support , the assumption that correct knowledge about schizophrenia can exert anti-stigma effects has been found to be reasonable but unrealistic in practice.
In particular, detailed knowledge of the efficacy, tolerability, pharmacokinetics and pharmacodynamics of the various antipsychotics is essential to tailor individualised pharmacotherapies to maximize the chances of improvement and minimize the risk of adverse events, two basic components for good adherence. Also the doctor’s competence in gathering information from the patient’s psychopharmacologic history is essential for individualised interventions. Another important issue for medication-taking behaviour that requires the competence and attention of the physician refers to the use of polypharmacy, a phenomenon that is in use worldwide and is expanding [7, 80, 81, 261–278].