Purpose The primary aim of this study was to assess the
September 28, 2017
Purpose The primary aim of this study was to assess the range of attitudes towards antipsychotic treatment at hospital discharge in patients with schizophrenia and bipolar disorder. was 43.1 years (standard deviation [SD] 12.1), and 55.8% were males. Twenty-six percent of the patients presented a negative attitude towards antipsychotic treatment (mean DAI-10 score of ?4.7, SD 2.7). NSC 87877 manufacture Most of them had a diagnosis of schizophrenia. Multivariate analysis showed that poor insight into illness and a greater number of previous acute episodes was significantly associated with a negative attitude towards medication at discharge (odds ratio 1.68 and 1.18, respectively). Conclusion Insight and clinical stability prior to admission were related to patients attitude towards antipsychotic treatment at hospital discharge among patients with schizophrenia and bipolar disorder. The identification of factors related to the attitude towards medication would offer an improved opportunity for clinicians to select patients eligible for prophylactic adherence-focused interventions. 0.2) and confounding variables into the backward stepwise logistic regression model, aiming to identify factors associated with the sign of the Rabbit Polyclonal to GDF7 attitude towards antipsychotic medication. The correlation matrix for the independent variables was examined to detect potential multicollinearity problems in model building and to select the final candidate predictors to be included in the model based on clinical criteria. The final model contained only the independent variables that maintained a significant association with the outcome after adjustment ( 0.05), according to the likelihood ratio test. The variables used to adjust the initial model were: age, sex, living status, diagnosis, number of previous acute episodes, time since the last hospitalization, CGI-S score, and severity of adverse events. Time since the last acute episode variable was not included due to collinearity. All statistical tests were performed considering a significance level of 5%. The SAS statistical package (release 8.02; NSC 87877 manufacture SAS Institute Inc, Cary, NC), was used throughout. Results Of the 99 recruited patients, 86 were included NSC 87877 manufacture in the analysis (45 with a diagnosis of schizophrenia and 41 with bipolar disorder). Deviations from protocol (= 13) were due to failure to meet the screening criteria, such as length of hospital stay (= 7). The mean age was 43.1 years (SD 12.1), with males comprising 55.8% of the sample. The mean CGI-S score was 3.4 (SD 1.1). Table 1 summarizes the main sociodemographic and clinical characteristics of the sample. Table 1 Sociodemographic and clinical characteristics of the sample Attitude towards medication The mean DAI-10 score at discharge was 2.1 points (95% confidence interval [CI]: 1.0C3.2). A total of 74.4% (= 64) of the patients presented a positive attitude towards treatment. Most patients with a negative attitude had a diagnosis of schizophrenia (= 16/22, 72.7%) (Table 2). Table 2 Sociodemographic and clinical characteristics according to attitude towards treatment The mean ROMI total score was 44.3 (95% CI: 43.0C45.5), indicating a clear predominance of reasons for not complying with treatment. Analysis of the relationship between subjective attitude and reasons for compliance only revealed a direct relationship between the score obtained on the DAI-10 scale and the compliance subscale of the ROMI (= 0.5; < 0.0001). We found a larger number of patients with a negative attitude towards treatment among those who had been clinically stable (event-free) for less time. Thus, patients who revealed a negative attitude had remained stable for a mean of 0.9 years (95% CI: 0.6C1.2), whereas patients with a positive attitude revealed a longer mean stability period of 3.7 years (95% CI: 2.2C5.2), with a mean difference between NSC 87877 manufacture groups of 2.8 (95% CI: of 1 1.9C4.2; = 0.0004). This finding was also confirmed both in patients with schizophrenia and in patients with bipolar disorder separately: the mean difference in clinical stability time based on attitude was 3.1 years (= 0.0218) and 2.9 years (= 0.0012), respectively. The mean SUMD score of patients with a positive attitude towards treatment was 6.6 (95% CI: 5.9C7.4), whereas in patients with a negative attitude the score was 10.1 (95% CI: 8.8C11.3). The difference between both groups was 3.5 (95% CI: 2.0C4.9; < 0.0001). An inverse relationship was observed between attitude towards treatment and patient insight at discharge: patients with a negative attitude obtained insight scores indicative of poorer disease awareness (= ?0.31; = 0.0039). The subsequent analysis by subgroups only confirmed this result among patients with schizophrenia with a mean difference between groups based on attitude of 3.7 (95% CI: 1.9C5.6). Multivariate analysis showed insight into illness and the number of previous acute episodes to be related to patient attitude towards treatment at discharge. Patients with.