Medication adherence in schizophrenia

Table 2 Identified risk factors for non-adherence by patients with schizophrenia

Patient-related risk factors

Sociodemographic factors

Younger and older patients

Male

General clinical factors

Drugs or alcohol consumption

Previous non-adherence

Psychopathological symptoms

Impaired insight

Cognitive deficiency

Delusion of persecution, poisoning or grandeur

Psychotic symptoms

Negative symptoms

Psychological factors: attitudes, beliefs and other subjective aspects

Negative attitude toward the treatment

Negative subjective response to treatment

Regarding the disease as mild and/or perceived minor benefit from treatment

Shame or stigmatization associated with the medication or the disease

Environment-related risk factors

Poor social and familial support

Negative social perception of the disease

Stigmatization

Difficulty accessing healthcare services

Physician-related risk factors

Poor relationship with the therapist

Poor psychoeducation and information to patients and relatives

Poor contact with the therapist

Inadequate planning of the post-discharge period

Treatment-related risk factors

Ineffectiveness against persistent symptoms (psychotic and negative symptoms)

Fear of adverse effects

Complex medication schedule

Poorer adherence to oral than to intramuscular treatments