Compliance therapy: A randomised controlled trial in schizophrenia

Objective: To evaluate the efficacy of "compliance therapy" for improving adherence to prescribed drug treatment among patients with schizophrenia. Design: Randomised controlled trial. Setting: Urban catchment area psychiatric service. Participants: 94 consecutive admissions of patients with schizophrenia, 56 agreed to participate. Intervention: Compliance therapy and non-specific counselling, each consisting of 5 sessions lasting 30-60 minutes. Main outcome measures Compliance with drug treatment at one year; attitudes to treatment, symptomatology, insight, and quality of life at one year; length of "survival" in the community, bed days, and rehospitalisation rates at two years. Results: Compliance therapy did not confer a major advantage over non-specific therapy in improving compliance at one year (43% (12/28) v 54% (15/28), difference - 11% (95% confidence interval - 37% to 15%) or in any of the secondary outcome measures-symptomatology, attitudes to treatment, insight, global assessment of functioning, and quality of life. Conclusion: Compliance therapy may not be of benefit to patients with schizophrenia. Attitudes to treatment at baseline predicted adherence one year later and may be a clinically useful tool.