Op maat gesneden interventie bevordert therapietrouw bij psychotische patiënten: een RCT*

Objective

To compare the effects of ‘Treatment adherence therapy’ (TAT) with standard treatment on treatment adherence, symptoms, quality of life, and the number of voluntary or involuntary admissions in patients with a psychotic disorder. TAT is a new treatment that takes into account individual reasons for non-adherence per patient.

Design

A randomised controlled trial (RCT) among 109 out-patients who were did not comply well with treatment. This RCT is registered in the Dutch Trial Registry: NTR1159.

Method

Tests were conducted to assess treatment adherence, symptoms and quality of life before intervention (t0), immediately following 6 months of intervention (t1), and after another 6 months follow-up (t2). These were predominantly performed by blinded interviewers. An ‘intention-to-treat’ multivariate analysis was used.

Results

In comparison with standard treatment TAT had a significantly more beneficial effect on medication adherence (Cohen’s d = 0.43) and on treatment compliance (Cohen’s d = 0.48). Results for medication adherence remained significant at 6-month follow-up. A trend was also found regarding involuntary admissions (1.9% versus 11.8%). Psychiatric symptoms and quality of life did not improve.

Conclusion

Treatment Adherence Therapy (TAT) improved treatment adherence, and may have prevented involuntary admissions.

Conflict of interest: Dr. A.B.P. Staring received an honorarium from RINO and NIMH for instructing professionals and a reimbursement from Dutch mental health (GGZ) institutions for presenting lectures. Dr. J.P. Selten received a reimbursement from Benecke Consultants for the development of educational presentations. Prof. A.J.M. Loonen received a reimbursement from Bristol-Myers Squibb for presenting a lecture and from AstraZeneca for translating a manuscript. His institution received a contribution from BMS for cooperation on a course. Financial support: Prof. C.L. Mulder’s institution received a grant for this study from the Netherlands Organisation for Health Research and Development (ZonMw).