Factors Associated with the Effectiveness of a Telephone-Based Nursing Strategy for Enhancing Medication Adherence in Schizophrenia

José Manuel Montes1, Jorge Maurino2, *, Teresa Diez2, Jerónimo Saiz-Ruiz3
1 Department of Psychiatry, Hospital del Sureste, Arganda del Rey, Madrid, Spain
2 AstraZeneca Medical Department, Madrid, Spain
3 Department of Psychiatry, Hospital Universitario Ramón y Cajal, Madrid, Spain

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© Montes et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Serrano Galvache, 56 Parque Norte, Edificio Roble (28033) Madrid, Spain; Tel: +34 913019738; Fax: +34 913019606; E-mail:


A post hoc analysis was made to identify factors associated with success following a 4-month telephone-based strategy for enhancing adherence to antipsychotic treatment in schizophrenia. A total of 928 stable outpatients were randomized to receive a monthly telephone call provided by a nurse or routine clinical care. Logistic regression with a backward stepwise procedure was used. A higher percentage of patients in the intervention group (25.7%, n=109) improved adherence at the end of the study compared with the control group (16.8%, n=74) (p=0.0013). The intervention was significantly associated with adherence improvement in those patients with a previous negative attitude towards medication (OR=4.7, 95% CI =2.4-9.0, p<0.0001). A slight concordance was obtained between adherence improvement and improvement in patient perception of treatment (kappa=0.21; 95% CI=0.15-0.27). The identification of factors related to the effectiveness of a specific intervention would offer clinicians the opportunity to more adequately select patients who are eligible for such intervention.

Keywords: Schizophrenia, medication adherence, mental health nursing, telephone, antipsychotic drugs.