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A Patient-Centered Antipsychotic Medication Adherence Intervention

Results From a Randomized Controlled Trial

Pyne, Jeffrey M. MD; Fischer, Ellen P. PhD; Mittal, Dinesh MD; Owen, Richard MD

The Journal of Nervous and Mental Disease: February 2018 - Volume 206 - Issue 2 - p 142–148
doi: 10.1097/NMD.0000000000000766
Original Articles

The purpose of this study was to develop and test a patient-centered and sustainable antipsychotic medication adherence intervention. The study design was a randomized controlled trial. Data from 61 patients diagnosed with schizophrenia or schizoaffective disorder were analyzed. The intervention included a checklist of barriers, facilitators, and motivators (BFM) for taking antipsychotic medications. The results of the checklist were summarized and a note was placed in the electronic medical record (EMR) and a hard copy was given to the patient. However, less than half of the BFM progress notes were placed in the EMR before the clinician visit as planned. The intervention significantly improved adherence at 6 months but not at 12 months and the intervention's effect on total Positive and Negative Syndrome Scale scores was not statistically significant. The BFM intervention is promising, but future studies are needed to improve the integration of the BFM intervention into typical clinic workflow.

Center for Mental Healthcare and Outcomes Research and South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock; and Division of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Send reprint requests to Jeffrey M. Pyne, MD, Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114. E-mail:

This study was supported by Veterans Affairs Health Services Research and Development Service Grant IIR 03-257-1. Identifier: NCT00144027.

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