The Effectiveness of a Theory-Based Integrated Intervention on Medication Adherence Among Community-Dwelling Individuals With Schizophrenia: A Quasi-Experimental Study.

Abstract

Introduction: Medication nonadherence remains a major recovery barrier for community-dwelling individuals with schizophrenia.

Aim: To evaluate a theory-based integrated medication-adherence intervention.

Method: This quasi-experimental study included 75 participants (39 experimental and 36 control). Medication adherence (Medication Adherence Rating Scale, MARS), psychiatric symptoms (Brief Psychiatric Rating Scale, BPRS), medication adherence motivation (University of Rhode Island Change Assessment, URICA) and medication attitudes (Drug Attitude Inventory-10, DAI-10) were assessed at baseline, 12 and 24 weeks. Repeated-measures ANOVA examined Group × Time interactions, change-from-baseline interaction contrasts and timepoint-specific between-group differences; rehospitalisation was assessed from medical records.

Results: Group × Time interactions were significant for MARS (p = 0.035, η_p ² = 0.047), BPRS (p = 0.042, η_p ² = 0.045), URICA (p = 0.003, η_p ² = 0.087) and DAI-10 (p = 0.004, η_p ² = 0.082). Between-group differences in change from baseline to Week 24 were significant for all outcomes, whereas from baseline to Week 12, a significant difference in change was observed only for DAI-10. At Week 24, between-group differences favoured the experimental group for MARS (1.186, 95% CI [0.261, 2.111]), URICA (1.507 [0.625, 2.389]) and DAI-10 (3.923 [1.743, 6.103]); the BPRS CI included zero. No rehospitalisations occurred.

Discussion: The intervention was associated with favourable medication-related outcomes; adherence effects were modest, symptom findings less conclusive and the non-randomised design limits causal inference.