New Research: Physicians May Significantly Overestimate How Reliably Patients Take Medication for Schizophrenia

Physicians significantly overestimate the extent to which patients with schizophrenia consistently take their prescribed medication, according to new research presented today at a major U.S. psychiatry meeting(1). Likewise, other data presented at the meeting document for the first time a direct correlation between symptom improvement and regular use of medication.

"We know that helping patients with schizophrenia stay on medication consistently over the long term is key to their ability to achieve and maintain maximum recovery," said Matthew Byerly, MD, assistant professor at the University of Texas Southwestern Medical Centre in Dallas, USA. "These data highlight the pressing need for clinicians to help patients find ways to take their medication more consistently."

In a three-month study of 21 individuals with schizophrenia, adherence to the prescribed medication regimen was measured in two different ways: physician perception and electronic monitoring of the actual opening of the medication bottle by the patient(2). The result: While electronic monitoring found that more than half of patients (13 of 20) were significantly non-adherent, physicians identified just 1 out of 20 patients as not taking their medication regularly.

In separate research conducted to document the relationship between treatment adherence and patient outcome, data were analysed from a one-year, multi-centre study of 565 individuals with schizophrenia who had experienced an acute episode of their illness just prior to enrolling. Patients were randomly assigned to receive treatment with either the atypical (newer-generation) antipsychotic Risperdal(R) (risperidone), or whichever conventional (typical) antipsychotic the treating physician considered to be best in their case. After the start of the assigned treatment, patients and physicians were allowed to proceed as they would normally -- stopping or switching treatments as necessary. The assessment of patients' adherence to treatment was based on whether a prescription drug had been prescribed or dispensed.

Patients' schizophrenic symptoms were assessed at the start of the research and at regular intervals using the PANSS (Positive and Negative Syndrome Scale). This is a commonly used scale that measures the severity of both "negative" symptoms (such as social withdrawal and apathy) and "positive" symptoms (including hallucinations and delusions).

The research found that 94% of patients received no antipsychotic therapy for some portion of the year and for half of them, adherence to treatment was 70 percent or less. Although individuals assigned to begin treatment with Risperdal experienced significantly greater symptom improvement than those who took a conventional drug, patients in both treatment groups experienced a highly statistically significant relationship between adherence with the prescribed medication regimen and symptom severity. Investigators found that a 20% drop in treatment adherence led to a 3.1 decrease in the PANSS score, indicating worsening symptoms. Overall, improvement in PANSS scores was significantly greater among patients with high rates of treatment adherence than those with lower levels.

"Common sense and the reports from our own patients tell us that stopping medication leads to poorer outcomes," said John Docherty, MD, lead investigator and president and CEO of Comprehensive NeuroSciences, Inc., a U.S.-based neuroscience research-management organisation. "But this study clearly demonstrates in a very concrete way that there is a direct, measurable correlation between symptom severity and even occasional failure to adhere to a medication regimen."

One approach to improving ongoing adherence to schizophrenia treatment is the use of long-acting formulations that require medication to be taken less frequently than once daily and that assure the delivery of more consistent levels of drug into the bloodstream. One such alternative is Risperdal Consta(TM) (risperidone microspheres), the first atypical antipsychotic to be available as a long-acting injection (requiring administration just once every two weeks). Risperdal Consta has been approved to date in the United Kingdom, Germany, the Netherlands, Switzerland, Austria, Mexico and New Zealand.

Notes to Editors:

1. The organisation does not permit in press releases the use of its name

or the city in which it meets.

2. Psychiatrists completed the Clinician Rating Scale, a seven-point scale

that assesses physicians' perceptions of patients' medication-taking

behavior, ranging from "complete refusal" (a score of 1) to "active

participation" (a score of 7). A score of 4 or less was considered

problematic. For a more objective, firsthand assessment, an electronic

monitoring device (called the MEMS(R) cap) was fitted to the medication

bottle dispensed to patients, which recorded how often the container was

opened and at what time of day. Significant non-adherence to treatment

was signaled when the number of bottle openings recorded was 70% or

fewer than what would be expected from the prescribed regimen.

Risperdal Consta(TM) is marketed in most areas of the world by the Janssen-Cilag companies, which are affiliates of Johnson & Johnson, the world's most diversified healthcare corporation. The companies have a long track record in developing and marketing treatments for central nervous system disorders, pain management, fungal infections and gastrointestinal conditions. Leading products include Eprex(R) (epoetin alfa), Risperdal(R) (risperidone), Sporanox(R) (itraconazole), Durogesic(R) (transdermal fentanyl), Topamax(R) (topiramate), Pariet(R) (rabeprazole sodium) and Reminyl(R) (galantamine). More information can be found at http://www.psychiatry24x7.com or http://www.janssen-cilag.com

SOURCE: Janssen-Cilag

CONTACT: Pam Rasmussen

Janssen-Pharmaceutica

+1 609 730 2986

[email protected]

Web site: http://www.psychiatry24x7.com

http://www.janssen-cilag.com

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--Distributed by AsiaNet (www.asianetnews.net)--

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