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.

ERIM Article Series (EAS)
British Journal of Psychiatry
Erasmus Research Institute of Management

Staring, A., Van Der Gaag, M., Koopmans, G., Selten, J. P., van Beveren, N., Hengeveld, M., … Mulder, N. (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