Medication supervision and adherence of persons with psychotic disorders in residential treatment settings: A pilot study

Background: Little is known about risk factors for and predictors of medica tion nonadherence within residential facilities. This pilot study examined the association between medication adherence and level of supervision and o ther environmental and clinical variables among patients with schizophrenia and related psychotic disorders living in supported housing. Method: A convenience sample of 74 adult residents with schizophrenia and r elated psychotic disorders (DSM-IV criteria) living in 4 supported housing facilities in New York City were assessed by their treating psychiatrist fo r medication cessation during the previous month. Demographic characteristi cs, medications, supervision, global function as measured by the Global Ass essment of Functioning (GAF), and substance abuse were also assessed. A pri ori hypotheses were that regimen complexity would be directly and medicatio n supervision would be inversely related to medication nonadherence. Results: In multivariate models, lack of direct medication supervision, neg ative medication attitude, and lower GAF score were associated with increas ed medication nonadherence in the recent past. Conclusion: This pilot study suggests that direct supervision of medication is associated with better adherence in residential treatment settings. Thi s finding is relevant for mental health service planners and clinicians wor king in these settings.