Predictors of poor adherence to medication among patients with first-episode schizophrenia-spectrum disorder

Aim: This study sought to identify predictors for poor adherence to medication among patients with first-episode schizophrenia-spectrum disorder. Methods: Medication adherence was measured 1 and 2 years after initiation of antipsychotic medication in a follow-up study of 547 patients. Relevant variables were systematically assessed at baseline, 1- and 2-year follow up. Results: Most patients have difficulties with medication adherence over time. Negative attitudes towards medication and lack of consistent family support are the strongest predictors for poor adherence to medication for first-episode psychotic patients in the first 2 years. After 1 year of treatment, unawareness of the effect of medication, lack of positive attitudes towards medication, substance abuse, young age and high global functioning also predict poor adherence to medication. Conclusions: A number of variables were independently associated with poor adherence. Rating of insight and attitudes towards medication makes it possible to predict poor adherence in incident cases with schizophrenia.