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Lessening the Side Effect Burden to Improve Adherence Among Individuals With Schizophrenia
Overview
Patients may be more willing to accept some adverse effects than others. Dr Kane offers advice on addressing side effects that prevent patients from maintaining their medication adherence.
Target Audience
- Psychiatrists
- Psychiatric nurse practitioners (NPs)
- Psychiatric physician assistants (PAs)
Learning Objective
Address adverse events that affect adherence in patients with schizophrenia
Abstract
In the treatment of schizophrenia, whereas clinicians tend to put great emphasis on symptom resolution and functioning as treatment goals, patients put greater value on well-being and quality of life. Many patients may experience more distress related to adverse effects than clinicians realize. Adverse effects are a frequent reason for nonadherence, which may lead to negative treatment outcomes, including structural brain changes, worsening symptoms, and increased treatment resistance when medication is resumed. By evaluating adherence and patients’ reasons for nonadherence, clinicians can try to address problems such as adverse events that prevent patients from maintaining their medication regimens.
From the Series: Overcoming Adherence Issues and Providing Patient-Centered Care for People Living With Schizophrenia
To cite: Kane JM. Lessening the side effect burden to improve adherence among individuals with schizophrenia. J Clin Psychiatry. 2021;82(2):IC20018BR1C.
To share: https://doi.org/10.4088/JCP.IC20018BR1C
© Copyright 2021 Physicians Postgraduate Press, Inc.
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Support Statement
Supported by an educational grant from Intra-Cellular Therapies, Inc.
Learning Objective
After completing this educational activity, you should be able to:
Address adverse events that affect adherence in patients with schizophrenia
Release, Review, and Expiration Dates
This brief report activity was published in March 2021 and is eligible for AMA PRA Category 1 Credit™ through March 31, 2023. The latest review of this material was January 2021.
Statement of Need and Purpose
The goals of schizophrenia treatment are to control symptoms, prevent relapse, and improve functioning and quality of life. For many patients, these goals are not being met. Unfortunately, clinicians often make decisions that are not concordant with clinical evidence or guidelines. Psychiatrists cite personal experience as the factor that most influences their decision-making about treatment for patients with schizophrenia. Clinicians are often not taking a patient-centered approach to schizophrenia treatment selection; thus, patients feel uninvolved in the choice of their treatment and report less satisfaction with care. Guidelines recommend taking into account not only comorbid illness, concurrent medications, previous medication experiences, and side effect profiles but also patient preferences when selecting antipsychotics. Clinicians would benefit from a review of effective, evidence-based care to help patients improve adherence. They also need to know about new agents that may treat a broader range of symptoms and limit side effects that decrease patients’ adherence and must recognize the importance of adopting a patient-centered approach to schizophrenia treatment. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on schizophrenia.
Disclosure of Off-Label Usage
Dr Kane has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.
Review Process
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
Acknowledgment
This activity is derived from the teleconference series “Overcoming Adherence Issues and Providing Patient-Centered Care for People Living With Schizophrenia,” which was held in October–November 2020 and supported by an educational grant from Intra-Cellular Therapies, Inc. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.
Faculty Affiliation
John M. Kane, MD
The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
Financial Disclosure
The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines relevant financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosure is as follows:
John M. Kane MD, is a consultant for and has received honoraria from Acadia, Alkermes, Allergan, Dainippon Sumitomo, H. Lundbeck. Intracellular Therapies, Janssen Pharmaceutical, Johnson & Johnson, LB Pharmaceuticals, Merck, Minerva, Neurocrine, Otsuka, Reviva, Roche, Saladex, Sunovion, Takeda, and Teva; has received grant/research support from Otsuka, Lundbeck, Sunovion, and Janssen; and is a stock shareholder of Vanguard Research Group and LB Pharmaceuticals, Inc.
The Chair for this activity, Philip D. Harvey, PhD, is a consultant for Acadia, Alkermes, BioXcel, Boehringer Ingelheim, Intra Cellular Therapies, Minerva, Regeneron, and Sunovion; has received grant/research support from Stanley Medical Research Institute and Takeda; and has received other financial or material support for the Brief Assessment of Cognition in Schizophrenia.
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
Available Credit
- 0.50 AMA PRA Category 1 Credit™
- 0.50 Participation