Medication adherence using electronic monitoring in severe psychiatric illness: 4 and 24 weeks after discharge

Yujin Lee, Moon Soo Lee, Hyun Ghang Jeong, Hyun Chul Youn, Seung hyun Kim

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    15 Citations (Scopus)


    Objective: The purpose of this study was to examine post-hospitalization outpatient drug adherence in patients with severe psychiatric illness, including bipolar disorder and schizophrenia, and to investigate factors associated with drug adherence. Methods: Eighty-one patients diagnosed with schizophrenia or bipolar disorder who were hospitalized due to aggravation of psychiatric symptoms were monitored. At hospitalization, we conducted clinical assessments such as the Clinical Global Impression-Severity, Drug Attitude Inventory, Contour Drawing Rating Scale, Multidimensional Scale of Perceived Social Support scale, and patients' demographic factors. We measured drug adherence using the Medication Event Monitoring System (MEMS), pill count, and patients' self-report upon out-patients visits, 4 and 24 weeks after discharge. Results: The mean values of the various measures of adherence were as follows: MEMS (4 weeks) 84.8%, pill count (4 weeks) 94.6%, self-report (4 weeks) 92.6%, MEMS (24 weeks) 81.6%, pill count (24 weeks) 90.6%, and self-report (24 weeks) 93.6%. The adherence agreement between MEMS, pill count, and self-report was moderate (4 weeks intraclass correlation [ICC]=0.54, 24 weeks ICC=0.52). Non-adherence (MEMS 0.08) was observed in 26.4% of the patients at 4 weeks and 37.7% at 24 weeks. There was a negative correlation between drug adherence assessed 4 weeks after discharge and Contour Drawing Rating Scale difference score (r=0.282, p0.05). A positive correlation was found between drug adherence assessed 24 weeks after discharge and Drug Attitude Inventory (r=0.383, p0.01). Conclusion: Patients' attitude towards their medication and their degree of physical dissatisfaction influenced post-hospitalization drug adherence in severe psychiatric patients.

    Original languageEnglish
    Pages (from-to)288-296
    Number of pages9
    JournalClinical Psychopharmacology and Neuroscience
    Issue number2
    Publication statusPublished - 2019 May

    Bibliographical note

    Funding Information:
    This study was supported by Hanlim Pharmaceuticals (Prof. Kim). The manuscript includes parts of a thesis by Yujin Lee.

    Publisher Copyright:
    © 2019 Korean College of Neuropsychopharmacology. All rights reserved.


    • Adherence
    • Bipolar disorder
    • Drug monitoring
    • Medication Event Monitoring System
    • Schizophrenia

    ASJC Scopus subject areas

    • Psychiatry and Mental health
    • Behavioral Neuroscience
    • Pharmacology (medical)


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