EFFECTIVENESS OF MOTIVATIONAL INTERVIEWING-BASED ADHERENCE THERAPY WITH FAMILY SUPPORT PROGRAM ON MEDICATION ADHERENCE FOR PERSONS WITH SCHIZOPHRENIA: A RANDOMIZED CONTROLLED TRIAL

Abstract

Adherence to pharmacological treatment is essential for schizophrenic persons, and maintaining medication compliance, especially in the first 5 years after the initial diagnosis, is recommended. It helps recovery and reduces the incidence of relapse and rehospitalization. This randomized controlled trial study aimed to examine the effectiveness of motivational interviewing-based adherence therapy [MIAT] with family support on medication adherence among persons with schizophrenia. The sample included patients with schizophrenia who met the study inclusion criteria and attended the psychiatric outpatient department at Buddhasothorn hospital. Participants were randomly assigned into intervention (n = 17) and control groups (n = 20). The participants in the intervention group and their family caregivers participated in MIAT with family support program. The program duration was five weeks and comprised six sessions. Medication adherence was assessed through 3 indicators including insight into illness using the Insight and Treatment Attitude Questionnaire, adherence attitude using the Hogan Drug Attitude Inventory, and adherence behavior using the Medication Adherence Questionnaire. These questionnaires had Cronbach’s alpha reliabilities of .82, .83, and .82, respectively. Data were collected at pre-test, post-test and 1 month follow-up. Descriptive statistics, t-tests, and 2-way repeated measures ANOVA were employed to analyze the data.

The results showed that after completing the intervention, the insight into illness and adherence attitude of participants in the intervention group was significantly higher than those in the control group (F1,109 = 8.111, p = .005; F1,109 = 4.809, p = .030) respectively. Within the intervention group, there were statistically significant differences in insight into illness, adherence attitude, and adherence behavior from pre-test to post-test to follow-up (F2,105 = 4.735, p = .011; F2,105 = 4.752, p = .011; F2,105 = 10.430, p = .000) respectively. The program could enhance medication adherence, especially insight and adherence attitude. Psychiatric and mental health care nurses should be trained in this program and apply it in their practices in order to promote medical adherence among these persons, especially those in an early stage of illness.

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