Use of the Medication Event Monitoring System to estimate medication compliance in patients with schizophrenia

Objective: To determine the feasibility of using the Medication Event Monit oring System (MEMS) to estimate medication compliance in patients with schi zophrenia or schizoaffective disorder. Subjects and setting: Fourteen of 35 consecutive patients admitted to a psychiatric inpatient hospital with sch izophrenia or schizoaffective disorder who met eligibility requirements and gave informed consent. Intervention: After random assignment to either ris peridone or typical antipsychotic treatment, medication upon discharge from hospital was dispensed in a bottle with a MEMS cap which recorded the numb er of bottle openings and the date and time of each opening. The first 6 pa tients were asked to return monthly for data downloading. The next 8 were a sked to return weekly during the first month and every 2 weeks thereafter; they were also paid $5 for returning each bottle. Outcome measures: MEMS da ta collected over a 6-month period and hospital readmission data. Results: Patient medication compliance data were collected from 10 (71%) of 14 patie nts during the first month, from 7 (58%) of 12 (2 patients dropped out) dur ing the second and from 5 (45%) of 11 (a third patient dropped out) during months 3-6. Mean compliance rates were 63% for the first month and ranged f rom 56% to 45% over the next 5. First-month compliance rates were significa ntly lower for those who were subsequently readmitted to hospital (n = 7) t han for those who were not (p < 0.01). Conclusions: Electronic monitoring d evices can be used to estimate compliance with medication regimens in patie nts with severe schizophrenic disorders, but there are methodological impro vements that can be made to increase data recovery and compliance, and thes e are discussed.