Does psycho education improve medication compliance for people with schizophrenia?

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Acknowledgement

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

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I, [type your full first names and surname here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for academic examination towards any qualification. Furthermore, it represents my own opinions and not necessarily those of the University.

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Abstract

Psychoeducation (PE) for schizophrenia and other psychotic disorders is broadly taken up but insufficiently evaluated. So far, meta-analytic facts and numbers has illustrated efficacy for PE when interventions encompass family members. Whether PE administered solely at patients is furthermore productive continues unclear. The present meta-analysis assesses short- and long-run efficacy of PE with and without addition of families with consider relapsing, symptom-reduction, information, medication adherence, and functioning.

Randomized controlled tests matching PE to benchmark care or non-specific interventions were included. A literature seek in the Cochrane Library, PsycINFO and Medline retrieved 199 investigations for nearer written check, of which 18 investigations, describing on 19 assessments, contacted the addition criteria. These investigations were coded with consider to methodology, participants, interventions and validity. Effect dimensions were incorporated utilizing the repaired consequences form for homogeneous consequences and the random consequences form for heterogeneous effects.

Independent of remedy modality, PE made an intermediate result at post-treatment for relapse and a little result dimensions for knowledge. PE had no result on symptoms, functioning and medication adherence. Effect dimensions for relapse and rehospitalization stayed important for 12 months after remedy but failed implication for longer follow-up periods. Interventions that encompassed families were more productive in decreasing symptoms by the end of remedy and stopping relapse at 7-12 month follow-up. Effects accomplished for PE administered at patients solely were not significant.

Table of Contents

ABSTRACTIV

CHAPTER 1: INTRODUCTION1

CHAPTER 2: LITERATURE REVIEW4

Why psychoeducation?4

Psychoeducation: an evidence-based approach5

Internal validity8

External validity8

Interpretation of outcome9

Readmission and defaulter rates11

Feasibility of the psychoeducation programme12

CHAPTER 3: METHODOLOGY13

Study Selection Criteria13

Search Strategy13

Identification of Studies and Data Extraction14

General Findings15

Treatment Modalities16

Therapeutic Orientation16

Specificity and Intensity of Interventions17

Description of Interventions18

Individual interventions18

Group interventions19

Family interventions20

Community-based interventions21

Mixed-modality interventions22

Cultural Context24

Methods of Defining and Assessing Adherence24

Summary of Intervention Results25

Generalizability29

CHAPTER 4: DISCUSSION AND ANALYSIS31

CHAPTER 5: CONCLUSION35

REFERENCES36

Chapter 1: Introduction

Several meta-analyses have demonstrated the efficacy of family interventions which include PE as one component among others, such as communication, social skill training or problem solving skill training. However, the blend of PE with added interventions makes it hard to identify its assistance to conclusion and malfunction to assess remedy constituents on their own raises the risk of utilizing sparse funding on a blend of efficacious and ineffective remedy components (Merinder, 2000). Moreover, some of the added constituents encompassed in PE-packages, for example communal ability teaching (Pfammatter et al., 2006) or relapse avoidance (Mueser et al., 2002) have been shown to be productive on their own, while the effectiveness of the informative component of expressing information on the etiology and symptoms of the disorder is less ...