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Improving treatment adherence in your patients with schizophrenia: the STAY initiative

Bibliographic reference Cañas, Fernando ; Alptekin, Koksal ; Azorin, Jean Michel ; Dubois, Vincent ; Emsley, Robin ; et. al. Improving treatment adherence in your patients with schizophrenia: the STAY initiative. In: Clinical Drug Investigation, Vol. 33, no.2, p. 97-107 (2013)
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  1. Valenstein Marcia, Ganoczy Dara, McCarthy John F., Kim Hyungjin Myra, Lee Todd A., Blow Frederic C., Antipsychotic Adherence Over Time Among Patients Receiving Treatment for Schizophrenia : A Retrospective Review, 10.4088/jcp.v67n1008
  2. National Institute for Health and Clinical Excellence (NICE) 2009. Medicines Adherence Clinical Guideline CG76. Available from URL: [Accessed 2012 Nov 14].
  3. Coldham E. L., Addington J., Addington D., Medication adherence of individuals with a first episode of psychosis, 10.1034/j.1600-0447.2002.02437.x
  4. Weiden PJ, Zygmut A. Medication noncompliance in schizophrenia. Part I: Assessment. J Pract Psych Behav Health. 1997;3:106–10.
  5. Peuskens J., Olivares J.M., Pecenak J., Tuma I., bij de Weg H., Eriksson L., Resseler S., Akhras K., Jacobs A., , Treatment retention with risperidone long-acting injection: 24-month results from the Electronic Schizophrenia Treatment Adherence Registry (e-STAR) in six countries, 10.1185/03007990903488670
  6. Alonso Jordi, Croudace Tim, Brown Jacqueline, Gasquet Isabelle, Knapp Martin R.J., Suárez David, Novick Diego, Health-Related Quality of Life (HRQL) and Continuous Antipsychotic Treatment: 3-year Results from the Schizophrenia Health Outcomes (SOHO) Study, 10.1111/j.1524-4733.2008.00495.x
  7. Perkins Diana O., Gu Hongbin, Weiden Peter J., McEvoy Joseph P., Hamer Robert M., Lieberman Jeffrey A., Predictors of Treatment Discontinuation and Medication Nonadherence in Patients Recovering From a First Episode of Schizophrenia, Schizophreniform Disorder, or Schizoaffective Disorder : A Randomized, Double-Blind, Flexible-Dose, Multicenter Study, 10.4088/jcp.v69n0114
  8. Lacro Jonathan P., Dunn Laura B., Dolder Christian R., Leckband Susan G., Jeste Dilip V., Prevalence of and Risk Factors for Medication Nonadherence in Patients With Schizophrenia : A Comprehensive Review of Recent Literature, 10.4088/jcp.v63n1007
  9. NOSÉ M., BARBUI C., TANSELLA M., How often do patients with psychosis fail to adhere to treatment programmes? A systematic review, 10.1017/s0033291703008328
  10. Ascher-Svanum Haya, Faries Douglas E., Zhu Baojin, Ernst Frank R., Swartz Marvin S., Swanson Jeff W., Medication Adherence and Long-Term Functional Outcomes in the Treatment of Schizophrenia in Usual Care, 10.4088/jcp.v67n0317
  11. Novick Diego, Haro Josep Maria, Suarez David, Perez Victor, Dittmann Ralf W., Haddad Peter M., Predictors and clinical consequences of non-adherence with antipsychotic medication in the outpatient treatment of schizophrenia, 10.1016/j.psychres.2009.05.004
  12. Wiersma D., Nienhuis F. J., Slooff C. J., Giel R., Natural Course of Schizophrenic Disorders: A 15-Year Followup of a Dutch Incidence Cohort, 10.1093/oxfordjournals.schbul.a033315
  13. Lieberman JA, Koreen AR, Chakos M, et al. Factors influencing treatment response and outcome of first-episode schizophrenia: implications for understanding the pathophysiology of schizophrenia. J Clin Psychiatry. 1996;57(Suppl. 9):5–9.
  14. Knapp M., King D., Pugner K., Lapuerta P., Non-adherence to antipsychotic medication regimens: associations with resource use and costs, 10.1192/bjp.184.6.509
  15. Sun Shawn X., Liu Gordon G., Christensen Dale B., Fu Alex Z., Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States, 10.1185/030079907x226050
  16. American Psychiatric Association (APA). Practice guidelines for the treatment of patients with schizophrenia 2004. 2nd ed. Available from URL:§ionid=1665359 [Accessed 2012 Nov 14].
  17. Velligan DI, Weiden PJ, Sajatovic M, et al. The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. J Clin Psychiatry. 2009;70(Suppl. 4):1–46.
  18. Masand Prakash S., Roca Miquel, Turner Martin S., Kane John M., Partial Adherence to Antipsychotic Medication Impacts the Course of Illness in Patients With Schizophrenia : A Review, 10.4088/pcc.08r00612
  19. Weiden Peter J., Kozma Chris, Grogg Amy, Locklear Julie, Partial Compliance and Risk of Rehospitalization Among California Medicaid Patients With Schizophrenia, 10.1176/
  20. Perkins DO. Adherence to antipsychotic medication. J Clin Psychiatry. 1999;60(Suppl. 21):25–30.
  21. Hogan Thomas P., Awad A. G., Eastwood Robin, A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity, 10.1017/s0033291700050182
  22. Morisky Donald E., Green Lawrence W., Levine David M., Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence : , 10.1097/00005650-198601000-00007
  23. Thompson K, Kulkarni J, Sergejew A.A, Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses, 10.1016/s0920-9964(99)00130-9
  24. Dolder Christian R., Lacro Jonathan P., Warren Kathleen A., Golshan Shahrokh, Perkins Diana O., Jeste Dilip V., Brief Evaluation of Medication Influences and Beliefs : Development and Testing of a Brief Scale for Medication Adherence, 10.1097/
  25. Byerly Matthew J., Nakonezny Paul A., Rush A. John, The Brief Adherence Rating Scale (BARS) validated against electronic monitoring in assessing the antipsychotic medication adherence of outpatients with schizophrenia and schizoaffective disorder, 10.1016/j.schres.2007.12.470
  26. Clayton Carol D., Veach Jeffrey, Macfadden Wayne, Haskins John, Docherty John P., Lindenmayer Jean-Pierre, Assessment of Clinician Awareness of Nonadherence Using a New Structured Rating Scale : , 10.1097/01.pra.0000375712.85454.c6
  27. Kemp R., Hayward P., Applewhaite G., Everitt B., David A., Compliance therapy in psychotic patients: randomised controlled trial, 10.1136/bmj.312.7027.345
  28. Sikka R, Xia F, Aubert RE. Estimating medication persistency using administrative claims data. Am J Manag Care. 2005;11(7):449–57.
  29. Baumann P., Hiemke C., Ulrich S., Eckermann G., Gaertner I., Gerlach M., Kuss H.-J., Laux G., Müller-Oerlinghausen B., Rao M. L., Riederer P., Zernig G., The AGNP-TDM Expert Group Consensus Guidelines: Therapeutic Drug Monitoring in Psychiatry, 10.1055/s-2004-832687
  30. Cramer Joyce A., How Often Is Medication Taken as Prescribed? : A Novel Assessment Technique, 10.1001/jama.1989.03420220087032
  31. Misdrahi David, Verdoux Helene, Lançon Christophe, Bayle Franck, The 4-Point ordinal Alliance Self-report: a self-report questionnaire for assessing therapeutic relationships in routine mental health, 10.1016/j.comppsych.2008.06.010
  32. Weiss K. A., Smith T. E., Hull J. W., Piper A. C., Huppert J. D., Predictors of Risk of Nonadherence in Outpatients With Schizophrenia and Other Psychotic Disorders, 10.1093/oxfordjournals.schbul.a006943
  33. Frank Arlene F., The Role of the Therapeutic Alliance in the Treatment of Schizophrenia : Relationship to Course and Outcome, 10.1001/archpsyc.1990.01810150028006
  34. Davis Louanne W., Lysaker Paul H., Therapeutic Alliance and Improvements in Work Performance Over Time in Patients With Schizophrenia : , 10.1097/01.nmd.0000261954.36030.a1
  35. Wittorf Andreas, Jakobi Ute, Bechdolf Andreas, Müller Bernhard, Sartory Gudrun, Wagner Michael, Wiedemann Georg, Wölwer Wolfgang, Herrlich Jutta, Buchkremer Gerhard, The influence of baseline symptoms and insight on the therapeutic alliance early in the treatment of schizophrenia, 10.1016/j.eurpsy.2008.12.015
  36. Karow A., Pajonk F.-G., Reimer J., Hirdes F., Osterwald C., Naber D., Moritz S., The dilemma of insight into illness in schizophrenia: self- and expert-rated insight and quality of life, 10.1007/s00406-007-0768-5
  37. Fleischhacker WW, Hofer A, Hummer M. Managing schizophrenia: the compliance challenge. 2nd ed. London: Science Press; 2007.
  38. Amador XF, Johanson A-L. I am not sick I don’t need help! How to help someone with mental illness accept treatment. 2nd ed. Peconic: Vida Press; 2006.
  39. Aquila R, Weiden PJ, Emanuel M. Compliance and the rehabilitation alliance. J Clin Psychiatry. 1999;60(Suppl. 19):23–7.
  40. Green Carla A., Polen Michael R., Janoff Shannon L., Castleton David K., Wisdom Jennifer P., Vuckovic Nancy, Perrin Nancy A., Paulson Robert I., Oken Stuart L., Understanding how clinician-patient relationships and relational continuity of care affect recovery from serious mental illness: STARS study results., 10.2975/32.1.2008.9.22
  41. Llorca Pierre-Michel, Partial compliance in schizophrenia and the impact on patient outcomes, 10.1016/j.psychres.2007.07.012
  42. Chakos Miranda, Lieberman Jeffrey, Hoffman Elaine, Bradford Daniel, Sheitman Brian, Effectiveness of Second-Generation Antipsychotics in Patients With Treatment-Resistant Schizophrenia: A Review and Meta-Analysis of Randomized Trials, 10.1176/appi.ajp.158.4.518
  43. Bagnall A-.M., Jones L., Ginnelly L., Lewis R., Glanville J., Gilbody S., Davies L., Torgerson D., Kleijnen J., A systematic review of atypical antipsychotic drugs in schizophrenia, 10.3310/hta7130
  44. Schulz S.Charles, Thomson Ruth, Brecher Martin, The efficacy of quetiapine vs. haloperidol and placebo: a meta-analytic study of efficacy, 10.1016/s0920-9964(02)00522-4
  45. Haddad Peter M, Sharma Sonu G, Adverse Effects of Atypical Antipsychotics : Differential Risk and Clinical Implications, 10.2165/00023210-200721110-00004
  46. Leucht Stefan, Corves Caroline, Arbter Dieter, Engel Rolf R, Li Chunbo, Davis John M, Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis, 10.1016/s0140-6736(08)61764-x
  47. Allison DB, Mentore JL, Heo M, et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156(11):1686–96.
  48. Baptista T., Zarate J., Joober R., Colasante C., Beaulieu S., Paez X., Hernandez L., Drug Induced Weight Gain, an Impediment to Successful Pharmacotherapy: Focus on Antipsychotics, 10.2174/1389450043490514
  49. Lieberman Jeffrey A., Stroup T. Scott, McEvoy Joseph P., Swartz Marvin S., Rosenheck Robert A., Perkins Diana O., Keefe Richard S.E., Davis Sonia M., Davis Clarence E., Lebowitz Barry D., Severe Joanne, Hsiao John K., Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia, 10.1056/nejmoa051688
  50. Oehl M., Hummer M., Fleischhacker W. W., Compliance with antipsychotic treatment, 10.1034/j.1600-0447.2000.00016.x
  51. Kane JM. Review of treatments that can ameliorate nonadherence in patients with schizophrenia. J Clin Psychiatry. 2006;67(Suppl. 5):9–14.
  52. Ereshefsky L, Mannaert E. Pharmacokinetic profile and clinical efficacy of long-acting risperidone potential benefits of combining an atypical antipsychotic and a new delivery system. Drugs. 2005;6(3):129–37.
  53. Kane JM. Introduction: methods, commentary, and summary. J Clin Psychiatry. 2003;64(Suppl. 12):1–100.
  54. Zypadhera SmPC, December 2011 [online]. Available from URL: [Accessed 2012 Mar 27].
  55. Xeplion SmPC, October 2011 [online]. Available from URL: [Accessed 2012 Mar 27].
  56. Risperdal Consta SmPC, March 2012 [online]. Available from URL: [Accessed 2012 Mar].
  57. Aripiprazole long-acting injectable formulation Phase I trial. Safety and tolerability trial of aripiprazole IM depot treatment in adult subjects with schizophrenia stabilized on oral antipsychotics other than aripiprazole. March 2012 [online]. Available from URL: [Accessed 2012 Mar 27].
  58. Leucht Claudia, Heres Stephan, Kane John M., Kissling Werner, Davis John M., Leucht Stefan, Oral versus depot antipsychotic drugs for schizophrenia—A critical systematic review and meta-analysis of randomised long-term trials, 10.1016/j.schres.2010.11.020
  59. Tiihonen Jari, Haukka Jari, Taylor Mark, Haddad Peter M., Patel Maxine X., Korhonen Pasi, A Nationwide Cohort Study of Oral and Depot Antipsychotics After First Hospitalization for Schizophrenia, 10.1176/appi.ajp.2011.10081224
  60. Rosenheck Robert A., Krystal John H., Lew Robert, Barnett Paul G., Fiore Louis, Valley Danielle, Thwin Soe Soe, Vertrees Julia E., Liang Matthew H., Long-Acting Risperidone and Oral Antipsychotics in Unstable Schizophrenia, 10.1056/nejmoa1005987
  61. Haddad P. M., Taylor M., Niaz O. S., First-generation antipsychotic long-acting injections v. oral antipsychotics in schizophrenia: systematic review of randomised controlled trials and observational studies, 10.1192/bjp.195.52.s20
  62. Lehman A. F., Kreyenbuhl J., Buchanan R. W., Dickerson F. B., Dixon L. B., Goldberg R., Green-Paden L. D., Tenhula W. N., Boerescu D., Tek C., Sandson N., Steinwachs D. M., The Schizophrenia Patient Outcomes Research Team (PORT): Updated Treatment Recommendations 2003, 10.1093/oxfordjournals.schbul.a007071
  63. Canadian Psychiatric Association. Clinical practice guidelines: treatment of schizophrenia. Can J Psychiatry. 2005;50(13 Suppl. 1):7S–57S.
  64. Keith Samuel J., Kane John M., Partial Compliance and Patient Consequences in Schizophrenia : Our Patients Can Do Better, 10.4088/jcp.v64n1105
  65. Jaeger Matthias, Rossler Wulf, Attitudes towards long-acting depot antipsychotics: A survey of patients, relatives and psychiatrists, 10.1016/j.psychres.2008.11.003
  66. Chue Pierre, The relationship between patient satisfaction and treatment outcomes in schizophrenia, 10.1177/1359786806071246
  67. Fujikawa Midori, Togo Takashi, Yoshimi Asuka, Fujita Junichi, Nomoto Munetaka, Kamijo Atsushi, Amagai Toru, Uchikado Hirotake, Katsuse Omi, Hosojima Hideki, Sakura Yoshihisa, Furusho Ryo, Suda Akira, Yamaguchi Takayuki, Hori Taketo, Kamada Ayuko, Kondo Taizo, Ito Michitomo, Odawara Toshinari, Hirayasu Yoshio, Evaluation of subjective treatment satisfaction with antipsychotics in schizophrenia patients, 10.1016/j.pnpbp.2007.12.002
  68. Weiden Peter J., Schooler Nina R., Weedon Jeremy C., Elmouchtari Abdel, Sunakawa Ayako, Goldfinger Stephen M., A Randomized Controlled Trial of Long-Acting Injectable Risperidone vs Continuation on Oral Atypical Antipsychotics for First-Episode Schizophrenia Patients : Initial Adherence Outcome, 10.4088/jcp.09m05284yel
  69. Glazer William M., Byerly Mathew J., Tactics and technologies to manage nonadherence in patients with schizophrenia, 10.1007/s11920-008-0057-7
  70. Fanning Felicity, Foley Sharon, Lawlor Elizabeth, McWilliams Stephen, Jackson Deirdre, Renwick Laoise, Sutton Marie, Turner Niall, Kinsella Anthony, Trimble Timothy, O'Callaghan Eadbhard, Group cognitive behavioural therapy for first episode psychosis: who's referred, who attends and who completes it? : Group CBT for FEP: who's referred, who attends and completes it?, 10.1111/j.1751-7893.2011.00333.x
  71. National Institute for Health and Clinical Excellence (NICE) 2009. Schizophrenia Clinical Guideline CG82. Available from URL: [Accessed 2012 Nov 14].
  72. NOSE M., BARBUI C., GRAY R., TANSELLA M., Clinical interventions for treatment non-adherence in psychosis: meta-analysis, 10.1192/bjp.183.3.197
  73. Giner J, Cañas J, Olivares JM, et al. Treatment adherence in schizophrenia: a comparison between patient’s, relative’s and psychiatrist’s opinions [in Spanish]. Actas Esp Psiquiatr. 2006;34(6):386–92.
  74. Smerud Phyllis E., Rosenfarb Irwin S., The therapeutic alliance and family psychoeducation in the treatment of schizophrenia: An exploratory prospective change process study., 10.1037/0022-006x.76.3.505
  75. Guo Xiaofeng, Zhai Jinguo, Liu Zhening, Fang Maosheng, Wang Bo, Wang Chuanyue, Hu Bin, Sun Xueli, Lv Luxian, Lu Zheng, Ma Cui, He Xiaolin, Guo Tiansheng, Xie Shiping, Wu Renrong, Xue Zhimin, Chen Jindong, Twamley Elizabeth W., Jin Hua, Zhao Jingping, Effect of Antipsychotic Medication Alone vs Combined With Psychosocial Intervention on Outcomes of Early-Stage Schizophrenia : A Randomized, 1-Year Study, 10.1001/archgenpsychiatry.2010.105
  76. Buckley Peter F, Wirshing Donna A, Bhushan Prameet, Pierre Joseph M, Resnick Seth A, Wirshing William C, Lack of Insight in Schizophrenia : Impact on Treatment Adherence, 10.2165/00023210-200721020-00004
  77. Leucht S, Heres S. Epidemiology, clinical consequences, and psychosocial treatment of nonadherence in schizophrenia. J Clin Psychiatry. 2006;67(Suppl. 5):3–8.
  78. Pitschel-Walz G., Leucht S., Bauml J., Kissling W., Engel R. R., The Effect of Family Interventions on Relapse and Rehospitalization in Schizophrenia--A Meta-analysis, 10.1093/oxfordjournals.schbul.a006861
  79. Stroup T. S., McEvoy J. P., Swartz M. S., Byerly M. J., Glick I. D., Canive J. M., McGee M. F., Simpson G. M., Stevens M. C., Lieberman J. A., The National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Project: Schizophrenia Trial Design and Protocol Development, 10.1093/oxfordjournals.schbul.a006986
  80. Fleischhacker W. Wolfgang, Keet Ireneus P.M., Kahn René S., The European First Episode Schizophrenia Trial (EUFEST): Rationale and design of the trial, 10.1016/j.schres.2005.06.004
  81. McEvoy Joseph, Efficacy and Tolerability of Olanzapine, Quetiapine, and Risperidone in the Treatment of Early Psychosis: A Randomized, Double-Blind 52-Week Comparison, 10.1176/appi.ajp.164.7.1050
  82. Kikkert M. J., Schene A. H., Koeter M. W. J., Robson D., Born A., Helm H., Nose M., Goss C., Thornicroft G., Gray R. J., Medication Adherence in Schizophrenia: Exploring Patients', Carers' and Professionals' Views, 10.1093/schbul/sbl011
  83. Johnsen Erik, Jørgensen Hugo A, Effectiveness of second generation antipsychotics: A systematic review of randomized trials, 10.1186/1471-244x-8-31
  84. Dolder Christian R., Lacro Jonathan P., Leckband Susan, Jeste Dilip V., Interventions to Improve Antipsychotic Medication Adherence: Review of Recent Literature : , 10.1097/
  85. Brekke John S., Ansel Mark, Long Jeffrey, Slade Elizabeth, Weinstein Marvin, Intensity and Continuity of Services and Functional Outcomes in the Rehabilitation of Persons With Schizophrenia, 10.1176/ps.50.2.248
  86. Dirani R, Lindenmayer J-P, Crivera C, et al. Continuity of care in patients with schizophrenia and schizoaffective disorder. Clearwater Beach, Florida, USA. Poster presented at Quality of Behavioral Health Care Conference; 2010 April 13–14.
  87. Haddad P, Knapp M. Health professionals’ views of services in schizophrenia—fragmentation and inequality. Psych Bull. 2006;24:47–50. Available from URL: [Accessed 2012 Nov 14].
  88. Killaspy H. Importance of specialization in psychiatric services. Commentary on… How did we let it come to this? Psychatrist. 2012;36:364–5. Available from URL: [Accessed 2012 Nov 14].
  89. Lodge G. How did we let it come to this? A plea for the principle of continuity of care. Psychiatrist. 2012;36:361–3. Available from URL: [Accessed 2012 Nov 14].
  90. Gaebel Wolfgang, Riesbeck Mathias, Wölwer Wolfgang, Klimke Ansgar, Eickhoff Matthias, von Wilmsdorff Martina, Lemke Matthias, Heuser Isabella, Maier Wolfgang, Huff Wolfgang, Schmitt Andrea, Sauer Heinrich, Riedel Michael, Klingberg Stefan, Köpcke Wolfgang, Ohmann Christian, Möller Hans-Jürgen, , Relapse Prevention in First-Episode Schizophrenia—Maintenance vs Intermittent Drug Treatment With Prodrome-Based Early Intervention : Results of a Randomized Controlled Trial Within the German Research Network on Schizophrenia, 10.4088/jcp.09m05459yel
  91. Gaebel Wolfgang, Jänner Michaela, Frommann Nicole, Pietzcker Adolf, Köpcke Wolfgang, Linden Michael, Müller Peter, Müller-Spahn Franz, Tegeler Joachim, First vs multiple episode schizophrenia: two-year outcome of intermittent and maintenance medication strategies, 10.1016/s0920-9964(01)00182-7
  92. dosReis Susan, Johnson Elizabeth, Steinwachs Donald, Rohde Charles, Skinner Elizabeth A., Fahey Maureen, Lehman Anthony F., Antipsychotic treatment patterns and hospitalizations among adults with schizophrenia, 10.1016/j.schres.2007.12.475