Monday, March 14, 2016

Psychoeducation Improves Compliance, Outcomes in Patients With Schizophrenia

Psychoeducation appears to improve long-term medication adherence in patients with schizophrenia, leading to significantly fewer days spent in a hospital, according to a study published in Schizophrenia Bulletin. Despite taking a higher average dose of chlorpromazine, the patients in the trial did not experience significant increases in motor side effects when assessed at a seven-year follow-up.

These findings are a component of a large randomized, controlled trial known as the Munich PIP (Psychosis Information Project) study, which found that patients who participated in a program where they learned about the nature of their illness and the importance of treatment over the course of several months were more likely to adhere to their chlorpromazine regimen seven years later compared with patients who received standard guidance. As part of the main study analysis, the researchers found that the patients who received psychoeducation took more medication over time and had a lower rehospitalization rate at two-year and seven-year follow-ups.

In the current study, a group at the Technical University of Munich explored the potential of increased movement problems in a subset of 41 patients taking chlorpromazine (21 receiving psychoeducation and 20 controls) using both the standard rating scale (Abnormal Involuntary Movement Scale or AIMS) and a detailed series of kinematic tests (e.g., repetitive drawing and hand steadiness).

Despite taking a higher average daily dose of chlorpromazine (354 units versus 279 units), the patients in the psychoeducation group did not show any significant deficiencies in their assessed movement skills at the seven-year follow-up. Additionally, the researchers found patients in the intervention group had spent 74.7 days in a hospital compared with 243.4 days for the patients in the control group—about the same rates as the larger Munich PIP cohort.

“Psychoeducation can lead to a significant improvement of long-term outcome and save treatment costs, above all, by the reduced number of hospital days. Being better informed and thus better empowered, patients can positively influence their medical treatment and reduce side effects in the long run,” the authors wrote.

To read more about the potential value of psychoeducation in schizophrenia, see the Psychiatric News article “Psychosocial Treatments Found Effective for Early Psychosis.”

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