TY  - JOUR
T1  - Attitudes toward antipsychotic medication: The impact of clinical variables and relationships with health professionals
AU  - Day JC, Bentall RP, Roberts C, et al
Y1  - 2005/07/01
N1  - 10.1001/archpsyc.62.7.717
JO  - Archives of General Psychiatry
SP  - 717
EP  - 724
VL  - 62
IS  - 7
N2  - Context 
    Nonadherence to antipsychotic medication is a major cause of psychotic relapse and is strongly influenced by attitudes toward treatment. Although patient variables such as insight and symptoms that contribute toward attitudes have been identified, the contributions of relationship and service factors have not been adequately studied.Objective 
    To determine relations between clinical and service variables and attitudes toward medication in people with a diagnosis of schizophrenia and schizoaffective disorder.Design 
    Consecutively admitted patients were approached to take part; 23 refused. Measures included symptoms, insight, drug adverse effects, self-reported adherence, attitudes toward treatment, perceived relationship with the prescriber, ward atmosphere, and admission experience. Data were analyzed by a proportional odds model and structural equation modeling to test predicted paths between experience of admission, relationship variables, attitudes toward treatment, and self-reported adherence to medication.Setting 
    Twenty-eight inpatient wards at 8 hospitals in North Wales and the Northwest of England. Sites included hospitals with inner-city and rural catchment areas.Patients 
    Two hundred twenty-eight patients meeting DSM-IV criteria for schizophrenia or schizoaffective disorder, assessed during acute admission.Main Outcome Measures 
    Attitudes toward treatment and self-reported adherence to medication.Results 
    The data fit a model in which attitudes toward treatment were predicted by insight, relationship with staff (especially the physician-prescriber), and the patient’s admission experience (maximum likelihood χ249 = 89.3, P<.001). A poor relationship with the prescriber, experience of coercion during admission, and low insight predicted a negative attitude toward treatment.Conclusions 
    The quality of relationships with clinicians during acute admission appears to be an important determinant of patients’ attitudes toward treatment and adherence to medication. Enhancing such relationships may yield important clinical benefits.
SN  - 0003-990X
M3  - doi: 10.1001/archpsyc.62.7.717
UR  - http://dx.doi.org/10.1001/archpsyc.62.7.717
ER  -