g. belief that illness is a test sent by God to put them on the right path), and negatively in 26% (e.g. belief that illness is a punishment from God or a demon). Adherent patients had higher levels of group religious practice (at least once a month) than nonadherent patients. Treatment-related Calcitriol supplier factors Treatment-related factors such as adverse events and type of antipsychotic regimen were reviewed. Dosing regimen is another potentially important factor that Inhibitors,research,lifescience,medical may influence adherence;

therefore, this topic was addressed in a separate publication focusing only on this link [Medic et al. 2013]. Adverse events A prospective study [Hudson et al. 2004] found that approximately 35% of patients reported adverse drug Inhibitors,research,lifescience,medical reactions to be a barrier to medication adherence. Another prospective study [Loffler et al. 2003] assessed subjective reasons for noncompliance and found that 50% of patients reported distressed by side effects as a reason for noncompliance. The expert survey [Velligan et al. 2009] rated distress associated with persistent side effects (especially weight gain in women and excessive sedation) to be important contributors to adherence problems. Two studies (one

prospective study and one cross-sectional study) [Linden et al. 2001; Rettenbacher et al. 2004] found that adherent patients experienced more adverse events than nonadherent patients. These Inhibitors,research,lifescience,medical results could be explained by the higher risk of developing side effects in patients Inhibitors,research,lifescience,medical who take medications. These studies suggest that other factors made patients adherent despite experiencing the side effects of medication. However, a survey of patients did not find a correlation between experiencing side effects and omitting a dose [McCann et al. 2009]. The author mentions that this contrary finding may be explained by patients’ perceptions of the effectiveness of medications

being more central than the deterrent influence of side effects. Antipsychotic regimen The effect of the antipsychotic regimen was assessed in some studies. A prospective study [Janssen et al. 2006] which included 500 patients with schizophrenia in Germany Inhibitors,research,lifescience,medical Org 27569 found that patients who switched from a typical to an atypical antipsychotic had a significantly higher rate of medication adherence at discharge than those who did not switch (p < 0.001). Other factors that may have influenced adherence in this group may be the fact that patients who switched had fewer previous psychiatric admissions, shorter illness duration, a higher probability of being admitted voluntarily, and fewer substance disorders than those maintained on typical drugs [Weinmann, 2004]. A retrospective database study which analysed data from 63,214 patients [Valenstein et al. 2004] did not find a significant improvement in adherence as a result of using atypical agents; except with clozapine, when patients were unlikely to have poor adherence (OR 0.08; 95% CI 0.06–0.11).