Effectiveness of pharmaceutical care for improving medication‐related quality of life and adherence to treatment among people living with schizophrenia: a randomised controlled trial

Abstract

People living with schizophrenia frequently exhibit poor medication adherence because of adverse drug reactions (ADRs) or lack of disease awareness. This prospective randomised controlled trial investigated the benefits of pharmaceutical care delivered by hospital pharmacists for improving pharmacotherapy‐related quality of life and medication adherence among this patient group.The purpose of this study was to evaluate the effectiveness of pharmaceutical care interventions in enhancing medication adherence and improving the quality of life of people living with schizophrenia.Data were collected during inpatient and subsequent outpatient treatment from 6 January–8 June 2021. Participants were divided into two groups via block randomisation: a control group receiving standard treatment; and an intervention group receiving pharmaceutical care combined with standard treatment. The pharmaceutical care comprised medication review, monitoring of drug‐related problems (including ADRs), adjustment of the dose of antipsychotic medicines in collaboration with psychiatrists, and counselling of participants and caregivers about disease management before discharge. Pharmacotherapy‐related quality of life was assessed using the short version of the Patient‐Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT‐QoL), whereas medication adherence was evaluated using the Medication Taking Behaviour in Thai Patients (MTB‐Thai). The primary outcomes were the average change in the PROMPT‐QoL score from inpatient to outpatient care and the average outpatient MTB‐Thai score. Ethical approval was granted by the Srithanya Hospital Office of the Ethics Commission for Human Research (Reference no: STY.COA008/2564) and the study conforms to the Declaration of Helsinki. Informed consent was obtained from all patient and caregiver participants via a project information sheet and the completion of a written consent form.At the end of the study, compared with the control group, the intervention group exhibited a significantly lower ADR prevalence (57.90% vs 79.70%, p < 0.05) and a greater change in the mean PROMPT‐QoL scores pertaining to ‘obtaining information of medicines and diseases’, ‘impact of medicine side effects’, ‘ease of use of medicines’, and ‘therapeutic relationship’. In addition, the intervention group achieved a significantly higher mean of medicine adherence score than the control group (22.81 ± 1.61 vs 16.85 ± 3.00, p < 0.001).Pharmaceutical care may improve the outcomes of people living with schizophrenia by improving their quality of life, decreasing ADRs, and enhancing medication adherence.