Treatment adherence predicts QoL in schizophrenia
By Lucy Piper, Senior medwireNews Reporter
21 June 2013
Eur Psychiatry 2013; Advance online publication

medwireNews: Whether or not patients with schizophrenia adhere to treatment could directly impact on their quality of life (QoL), say researchers.

In a longitudinal study tracking the quality of life of patients with schizophrenia over the course of a 1-year randomized controlled study, they found improved adherence to treatment led to improved QoL.

"This has implications for how clinicians can promote the advantage of adherence to their patients and how the benefits of antipsychotics are viewed by other stakeholders," say researchers Karen Hayhurst (The University of Manchester, UK) and colleagues.

The team used the Quality of Life Scale (QLS) to assess 363 patients who had had schizophrenia for a median of 12 years. Over the course of a year, scores improved by an average 9.18 points. Improvements were also seen on the Positive and Negative Symptom Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS), with average decreases of 2.79 for positive symptoms, 3.03 for negative symptoms, and 2.56 for depressive symptoms.

Regression analysis showed that improvement in QLS scores was associated with changes in PANSS negative symptom subscale scores, change in CDSS depression scores, and improved treatment adherence, as measured using the Kemp 7-point scale.

As reported in European Psychiatry, these factors together explained 38% of variance in QLS change.

The researchers also note "that each of these change variables was a significant predictor of QLS change, individually."

Causal modeling showed the direction of these relationships, with change in depression and treatment adherence predicting change in QLS.

By contrast, change in QLS led to change in negative symptoms. The negative symptom items most strongly related to QLS were those associated with social functioning, such as social activity, emotional and social withdrawal, and poor rapport.

The researchers point out that "no side effects proved to be either significant correlates of change in QoL or determinants in the final regression model."

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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