Treatment adherence therapy in non-adherent patients with psychotic disorders; a randomised trial.

Non-adherence to treatment of patients with psychotic disorders is related to higher rates of relapse, hospitalization, and suicide. Attempts to improve adherence have shown that psychoeducation alone is not fully effective, and that motivational interviewing, behavioral strategies, and linking a patient’s personal goals to treatment may increase adherence. Based on the empirical data reviewed, we formed three clusters of possible causes of non-adherence, each of which can be targeted by a specific module of our developed Treatment Adherence Therapy (TAT). These three modules are: motivational interviewing, medication dosage trials, and behavioral training.

Treatment Adherence Therapy + Treatment as Usual (TAT+TAU), as compared to TAU-only, has a beneficial effect on treatment adherence, as defined by no-show contacts, the degree of collaboration in managing the illness, help seeking behaviour in crisis situations, and medication compliance.

T0 at baseline, T1 directly after completion of the intervention, T2 at six month follow-up. Each of the outcome measures mentioned above are assessed at all three timepoints.

The Treatment Adherence Therapy (TAT) protocol is an intervention consisting of about ten sessions in which one or a combination of the three available modules get applied during about six months. Each module targets a specific cause for non-adherence in patients with schizophrenia. In the two arms of the study, TAT + Treatment as Usual (TAU) gets compared with TAU-only.