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Compliance therapy: a randomised controlled trial in schizophrenia

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7419.834 (Published 09 October 2003) Cite this as: BMJ 2003;327:834
  1. Colin O'Donnell, registrar1,
  2. Gary Donohoe, clinical psychologist1,
  3. Louise Sharkey, registrar1,
  4. Nicholas Owens, registrar1,
  5. Maria Migone, registrar1,
  6. Raewynn Harries, clinical nurse specialist1,
  7. Anthony Kinsella, statistician2,
  8. Conall Larkin, consultant3,
  9. Eadbhard O'Callaghan, professor (eadbhard{at}iol.ie)4
  1. 1 Stanley Research Unit, Department of Adult Psychiatry, Cluain Mhuire Service, NewtownparkAvenue, Dublin, Republic of Ireland,
  2. 2 Dublin Institute of Technology, Kevin Street, Dublin,
  3. 3 Saint John of God Hospital, Stillorgan, County Dublin,
  4. 4 Department of Psychiatry, University College Dublin, St Vincent's University Hospital, Elm Park, Dublin
  1. Correspondence to: E O'Callaghan
  • Accepted 8 September 2003

Abstract

>Objective To evaluate the efficacy of “compliance therapy” for improving adherence to prescribed drug treatment among patients with schizophrenia.

Design Randomised controlled trial.

Setting Urban catchment area psychiatric service.

Participants 94 consecutive admissions of patients with schizophrenia, 56 agreed to participate.

Intervention Compliance therapy and non-specific counselling, each consisting of 5 sessions lasting 30-60 minutes.

Main outcome measures Compliance with drug treatment at one year; attitudes to treatment, symptomatology, insight, and quality of life at one year; length of “survival” in the community, bed days, and rehospitalisation rates at two years.

Results Compliance therapy did not confer a major advantage over non-specific therapy in improving compliance at one year (43% (12/28) v 54% (15/28), difference −11% (95% confidence interval −37% to 15%) or in any of the secondary outcome measures—symptomatology, attitudes to treatment, insight, global assessment of functioning, and quality of life.

Conclusion Compliance therapy may not be of benefit to patients with schizophrenia. Attitudes to treatment at baseline predicted adherence one year later and may be a clinically useful tool.

Footnotes

  • Contributors EO'C, GD, AK, and CL designed the study. CO'D, LS, NO, and MM conducted the baseline and outcome assessments. GD and RH delivered the therapy. GD, EO'C, and CO'D coordinated the study. CO'D, GD, AK, EO'C, and CL participated in the analyses. CO'D, EO'C, AK, and GD wrote the initial draft, and all authors participated in writing the final manuscript. All authors approved the final document. EO'C is guarantor for the study.

  • Funding This project was supported by the Stanley Medical Research Institute. GD was supported by an unrestricted educational grant from Eli Lilly (Ireland).

  • Competing interests None declared.

  • Ethical approval The study was approved by the Provincial Ethics Committee of the Hospitaller Order of Saint John of God.

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