Medication Supervision and Adherence of Persons With Psychotic Disorders in Residential Treatment Settings: A Pilot Study

Background: Little is known about riskfactors for and predictors of medication nonadherence withinresidential facilities. This pilot study examined the associationbetween medication adherence and level of supervision and otherenvironmental and clinical variables among patients withschizophrenia and related psychotic disorders living in supportedhousing.

Method: A convenience sample of 74 adultresidents with schizophrenia and related psychotic disorders(DSM-IV criteria) living in 4 supported housing facilities in NewYork City were assessed by their treating psychiatrist formedication cessation during the previous month. Demographiccharacteristics, medications, supervision, global function asmeasured by the Global Assessment of Functioning (GAF), andsubstance abuse were also assessed. A priori hypotheses were thatregimen complexity would be directly and medication supervisionwould be inversely related to medication nonadherence.

Results: In multivariate models, lack ofdirect medication supervision, negative medication attitude, andlower GAF score were associated with increased medicationnonadherence in the recent past.

Conclusion: This pilot study suggests thatdirect supervision of medication is associated with betteradherence in residential treatment settings. This finding isrelevant for mental health service planners and cliniciansworking in these settings.