Barbeito, S. 1, 2 , Ruiz de Azua, S. 1, 2, 4 , Msrtinez Cengotitabengoa, M. 1, 2, 3, 4 , González- Ortega, I. 1, 2, 4 , Bermundez Ampudia, C. 1, 2 & González Pinto, A. . 1, 2, 4
1 Osakidetza, Universitary hospital of alava
2 cibersam g10
3 uned
4 upv
Background: This study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients following over 8 years, especially involuntary first admission and stopping cannabis use.
Methods: This prospective, longitudinal study of FEP patients collected data on symptoms, adherence, functioning, and substance use. Adherence to treatment was the main outcome variable and was categorized as good or bad. Cannabis use during follow-up was stratified as continued use, stopped use, and never used. Bivariate and logistic regression models identified factors significantly associated with adherence and changes in adherence over the 8-year of following.
Results: Of 98 FEP patients analyzed at baseline, 57.1% had involuntary first admission, 74.4% bad adherence, and 52% cannabis use. Baseline good adherence was associated with Global Functioning score (p = 0.019), Hamilton Depression Scale (p = 0.017) and voluntary admission (p < 0.001). Adherence patterns over 8 years included: 43.4% patients always bad, 26.1% always good, 25% improved from bad to good. Among improved adherence group, 95.7% had involuntary first admission and 38.9% stopped cannabis use. In the subgroup of patients with bad adherence at baseline, involuntary first admission and quitting cannabis use during follow up were associated with improved adherence.
Conclusions: The long-term association between treatment adherence and type of first admission and cannabis use in FEP patients suggest targets for intervention to improve clinical outcomes.