A retrospective database study which analysed data from 35,815 patients [Marcus

and Olfson, 2008] reported that the fraction of acute care Panobinostat inpatient admissions attributable to not receiving antipsychotic medications was 12.3% (95% CI 11.7–12.6%) and the fraction of inpatient days attributable to not receiving antipsychotic medication was 13.1% (95% CI 9.8–16.5%) when a 15-day gap in the prescription record was used. Therefore, improving adherence by eliminating gaps in antipsychotic medication treatment could lower the number of acute care admissions and inpatient days. Discussion Antipsychotic medication is recognized as an essential component in the Inhibitors,research,lifescience,medical treatment of schizophrenia, and

adherence to medication plays a critical role in preventing symptoms and costly relapses. This study therefore Inhibitors,research,lifescience,medical reviewed the main factors and consequences of nonadherence based on 37 full papers. Several patient-related factors may contribute to increasing or decreasing medication adherence. Inhibitors,research,lifescience,medical The evidence suggests that sociodemographic factors such as gender [Acosta et al. 2009; Linden et al. 2001] and family/marital status [Acosta et al. 2009; Linden et al. 2001] do not influence adherence as the association between nonadherence and these variables were not significant in most studies. However, results were mixed concerning ethnicity [Aldebot and de Mamani, 2009; Valenstein et al. 2004], level of education [Acosta et al. 2009; Aldebot and de Mamani, 2009; Hudson et al. 2004; Janssen et al. 2006; Linden et al. 2001; Loffler et al. 2003] and age [Acosta et al. 2009; Linden et al. 2001; Valenstein

Inhibitors,research,lifescience,medical et al. 2004]. Lack of insight was significantly associated with nonadherence in all studies [Acosta et al. 2009; Aldebot and de Mamani 2009; Inhibitors,research,lifescience,medical Loffler et al. 2003; Olfson et al. 2006] except one [Linden et al. 2001]. The author of this study mentions that the contrary finding may be due to the selection of patients with expected better adherence. Substance abuse [Ascher-Svanum, 2006; Hudson et al. 2004; Janssen et al. 2006; Novick et al. 2010], negative medication beliefs [Linden et al. 2001; Loffler et al. 2003], and a prior poor adherence practice [Ascher-Svanum, 2006; Novick et only al. 2010] were found to be significantly associated with nonadherence. Treatment-related factors were also reviewed. Patients and experts reported adverse events to be a barrier to adherence [Hudson et al. 2004; Loffler et al. 2003; Velligan et al. 2009]. However, in two studies [Linden et al. 2001; Rettenbacher et al. 2004] adherence was good despite the presence of adverse events. Due to the mixed results, it is difficult to make a conclusion on the causal relation between adverse events and nonadherence. Patients who were on atypical agents tended to have better adherence [Valenstein et al. 2004].