Environment-related factors External or environment-related facto

Environment-related factors External or environment-related factors included relationship with physician, stigma of disease, living situation and KRX-0401 clinical trial family support. Relationship with physician A prospective study [Linden et al. 2001] found that both nonadherent and adherent patients had a good relationship with their physicians. However, adherent patients trusted their physicians significantly more, and they expected that physicians would be helpful in treatment (p < 0.05). Another prospective study [Loffler et al. 2003] found that 41% of patients considered

a positive relationship with physicians and therapists to be important for medication Inhibitors,research,lifescience,medical adherence. Furthermore, a review [Velligan et al. 2009] reported that the ‘positive relationship with clinical staff’ was a significant predictor of good adherence. However, ‘difficulties in building a therapeutic alliance’ and ‘poor Inhibitors,research,lifescience,medical clinician–patient relationship’ were

among significant predictors of nonadherence. A cross-sectional study [Rettenbacher et al. 2004] assessed a link between the person who inquires (i.e. psychiatrist, relatives Inhibitors,research,lifescience,medical or others) about drug intake and adherence. Forty-one percent of adherent patients were asked about drug intake most frequently by their psychiatrist while none of the nonadherent patients reported this (p = 0.074). Among nonadherent patients, a higher proportion (60% versus 9% of adherent patients) stated that their relatives inquired most often about their drug intake. Other environmental factors A prospective study [Hudson et al. 2004] found that the most common barriers to patient adherence to medication were related to the stigma of taking medication and lack of support. Furthermore, a review [Velligan et al. 2009] reported that predictors of nonadherence included a disorganized Inhibitors,research,lifescience,medical or chaotic living situation, financial problems, housing problems and logistic problems, while predictors of good adherence included family and social support. Greater social activity was also found to be a predictor of good adherence (OR 1.26; p < 0.001) Inhibitors,research,lifescience,medical [Novick et al. 2010]. Physician perception

on important factors of nonadherence In the expert survey [Velligan et al. 2009] on potential contributors to adherence problems in schizophrenia, experts were asked to rate factors as very important, somewhat important and not important for medication adherence. The factors rated as very important included ‘poor insight into having an illness’ and ‘distress associated with persistent SB-3CT side effects or fear of potential side effects’. The key factors out of 12 factors rated as somewhat important related to efficacy, beliefs about medication, substance abuse and social support. The survey revealed a wide range of factors that clinicians found to be the potential factors of nonadherence. Consequences of nonadherence Three main types of consequences of nonadherence included consequences to patients, society and healthcare systems.

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