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The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent...

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Autores principales: Aguglia, Andrea, Fusar-Poli, Laura, Amerio, Andrea, Placenti, Valeria, Concerto, Carmen, Martinotti, Giovanni, Carrà, Giuseppe, Bartoli, Francesco, D'Agostino, Armando, Serafini, Gianluca, Amore, Mario, Aguglia, Eugenio, Ostuzzi, Giovanni, Barbui, Corrado
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8716539/
https://www.ncbi.nlm.nih.gov/pubmed/34975581
http://dx.doi.org/10.3389/fpsyt.2021.784366
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author Aguglia, Andrea
Fusar-Poli, Laura
Amerio, Andrea
Placenti, Valeria
Concerto, Carmen
Martinotti, Giovanni
Carrà, Giuseppe
Bartoli, Francesco
D'Agostino, Armando
Serafini, Gianluca
Amore, Mario
Aguglia, Eugenio
Ostuzzi, Giovanni
Barbui, Corrado
author_facet Aguglia, Andrea
Fusar-Poli, Laura
Amerio, Andrea
Placenti, Valeria
Concerto, Carmen
Martinotti, Giovanni
Carrà, Giuseppe
Bartoli, Francesco
D'Agostino, Armando
Serafini, Gianluca
Amore, Mario
Aguglia, Eugenio
Ostuzzi, Giovanni
Barbui, Corrado
author_sort Aguglia, Andrea
collection PubMed
description Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network “Depot Study” was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS ≥ 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions—conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently—showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders.
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spelling pubmed-87165392021-12-31 The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study Aguglia, Andrea Fusar-Poli, Laura Amerio, Andrea Placenti, Valeria Concerto, Carmen Martinotti, Giovanni Carrà, Giuseppe Bartoli, Francesco D'Agostino, Armando Serafini, Gianluca Amore, Mario Aguglia, Eugenio Ostuzzi, Giovanni Barbui, Corrado Front Psychiatry Psychiatry Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network “Depot Study” was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS ≥ 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions—conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently—showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders. Frontiers Media S.A. 2021-12-16 /pmc/articles/PMC8716539/ /pubmed/34975581 http://dx.doi.org/10.3389/fpsyt.2021.784366 Text en Copyright © 2021 Aguglia, Fusar-Poli, Amerio, Placenti, Concerto, Martinotti, Carrà, Bartoli, D'Agostino, Serafini, Amore, Aguglia, Ostuzzi, Barbui and the STAR Network Investigators. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Aguglia, Andrea
Fusar-Poli, Laura
Amerio, Andrea
Placenti, Valeria
Concerto, Carmen
Martinotti, Giovanni
Carrà, Giuseppe
Bartoli, Francesco
D'Agostino, Armando
Serafini, Gianluca
Amore, Mario
Aguglia, Eugenio
Ostuzzi, Giovanni
Barbui, Corrado
The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study
title The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study
title_full The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study
title_fullStr The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study
title_full_unstemmed The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study
title_short The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study
title_sort role of attitudes toward medication and treatment adherence in the clinical response to lais: findings from the star network depot study
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8716539/
https://www.ncbi.nlm.nih.gov/pubmed/34975581
http://dx.doi.org/10.3389/fpsyt.2021.784366
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