Interventions to improve adherence to treatment in people with psychotic disorders have produced inconclusive results. We developed a new treatment, treatment adherence therapy (TAT), whose intervention modules are tailored to the reasons for an individual's non-adherence. Aims To examine the effectiveness of TAT with regard to service engagement and medication adherence in out-patients with psychotic disorders who engage poorly. METHOD: Randomised controlled study of TAT v. treatment as usual (TAU) in 109 out-patients. Most outcome measurements were performed by masked assessors. We used intention-to-treat multivariate analyses (Dutch Trial Registry: NTR1159). RESULTS: Treatment adherence therapy v. TAU significantly benefited service engagement (Cohen's d = 0.48) and medication adherence (Cohen's d = 0.43). Results remained significant at 6-month follow-up for medication adherence. Near-significant effects were also found regarding involuntary readmissions (1.9% v. 11.8%, P = 0.053). Symptoms and quality of life did not improve. CONCLUSIONS: Treatment adherence therapy helps improve engagement and adherence, and may prevent involuntary admission.

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Keywords psychiatry, psychotic disorders
Persistent URL dx.doi.org/10.1192/bjp.bp.110.077289, hdl.handle.net/1765/22102
Citation
Staring, A.B.P., van der Gaag, M., Koopmans, G.T., Selten, J.P., van Beveren, N.J.M., Hengeveld, M.W., … Mulder, C.L.. (2010). Treatment adherence therapy in people with psychotic disorders: randomised controlled trial. British Journal of Psychiatry, 197(6), 448–455. doi:10.1192/bjp.bp.110.077289