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Pharmacopsychiatry 2022; 55(06): 281-289
DOI: 10.1055/a-1804-6211
Original Paper

Factors Associated with Medication Adherence to Long-Acting Injectable Antipsychotics: Results from the STAR Network Depot Study

Andrea Aguglia   *
1   Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Italy
2   IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Laura Fusar-Poli   *
3   Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Via Santa Sofia, Catania, Italy
,
Antimo Natale
3   Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Via Santa Sofia, Catania, Italy
,
Andrea Amerio
1   Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Italy
2   IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Irene Espa
1   Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Italy
2   IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Veronica Villa
1   Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Italy
2   IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Giovanni Martinotti
4   Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti, Chieti, Italy
,
Giuseppe Carrà
5   Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore, Monza, Italy
6   Division of Psychiatry, University College London, Tottenham Court Rd, Bloomsbury, London, United Kingdom
,
Francesco Bartoli
5   Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore, Monza, Italy
,
Armando D’Agostino
7   Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Via Antonio di Rudinì, Milan, Italy
,
Gianluca Serafini
1   Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Italy
2   IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Mario Amore
1   Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Italy
2   IRCCS Ospedale Policlinico San Martino, Genoa, Italy
,
Eugenio Aguglia
3   Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Via Santa Sofia, Catania, Italy
,
Giovanni Ostuzzi
8   WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
,
Corrado Barbui
8   WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
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Abstract

Introduction Long-acting injectable (LAI) antipsychotics are prescribed to people with severe psychiatric disorders who show poor adherence to oral medication. The present paper examined factors potentially associated with medication adherence to LAI treatment.

Methods The STAR (Servizi Territoriali Associati per la Ricerca) Network Depot Study was a multicenter, observational, prospective study that enrolled 461 subjects initiating a LAI from 32 Italian centers. After 6 and 12 months of treatment, we evaluated differences between participants with high (≥5 points) and low (<5 points) medication adherence using Kemp’s 7-point scale in sociodemographic, clinical, psychopathological, and drug-related variables. Factors that differed significantly between the two groups were entered for multivariate logistic regression.

Results Six months after enrollment, participants with high medication adherence were younger, living with other people, had lower Brief Psychiatric Rating Scale (BPRS) total scores, lower adverse events, and a more positive attitude toward medication than participants with low adherence. Multivariate regression confirmed lower BPRS resistance and activation scores, absence of adverse events, and positive attitude toward medication as factors significantly associated with good adherence. After 12 months, all BPRS subscales were significantly lower in the high adherence group, which also showed a more positive attitude toward medication. BPRS resistance and attitude toward medication were confirmed as factors associated with medication adherence.

Discussion Our findings suggest that adherence to LAI is principally related to attitude toward medication and traits of suspiciousness/hostility. Quality of patient-clinician relationship and tailored psychoeducational strategies may positively affect adherence in people undergoing psychopharmacological treatment, including LAI.

Key words

long-acting injectable - antipsychotics - adherence - schizophrenia - bipolar disorder

* Shared first-authors




Publication History

Received: 08 February 2022
Received: 14 March 2022

Accepted: 16 March 2022

Article published online:
25 April 2022

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