Learning Objective #1: Describe prevalence of non-adherence in a psychosis population and be able to explain consequences of non-adherence to psychotropic medications

Learning Objective #2: Understand the complexity of medication adherence behaviors

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Aim: The primary aim of this pilot study was to examine whether Visual feedback (VF) therapy increased medication adherence rates to psychotropic medications. Research design: Experimental design. Intervention: Visual feedback therapy is a structured intervention, consisting of two components: 1) visual feedback of medication adherence behaviors based on chronology on computer screen created by electronic monitoring pill bottle (EM); 2) brief psychodynamic psychotherapy. The 40-minute VF sessions were delivered 7 times every 2 weeks for 3 months of the study period. Control group received supportive counseling only. Measurements: The primary adherence measure was EM and the blood plasma concentration level of drugs and pill counts were used to verify the primary measure. Study sample: The total number of 30 participants with DSM-IV psychotic disorders were recruited from two community mental health clinics. The mean age of the participants was 46.5, ranging from 29.0 to 63.0 (SD±8.62). Findings: Repeated measures ANOVA analysis controlling baseline difference was performed to test the major hypothesis. At 2, 4, 8, and 12 weeks, the mean adherence rates measured by EM for the supportive counseling group were 88.5%, 82.3%, 75.9%, and 68.4%; and for the VF group, 78.4%, 90.0%, 85%, and 87.9%. The adherence rates in the control group constantly declined, but overall adherence rates of the VF group increased except for a slight decline at 8 weeks (F=3.67, df=3, p=0.026). Plasma concentration level of drug was found in reference therapeutic ranges for 71.4% of the comparison group and 78.6% of the VF group at baseline. Participants whose drug plasma concentration either declined or stayed at the same level were compared by group to those whose concentration increased. VF groups had a higher percentage of participants whose drug plasma level increased (c2=5.250, df=1, p=.022). Conclusion: Compared to control group, VF increased medication adherence rates over time.