The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #54462

J. Gary Linn, PhD, School of Nursing, Tennessee State University, 1406 Beechwood Avenue, Nashville, TN 37212, 615-297-1354, jlinn87844@aol.com, James Harris, DNS, VA Tennessee Valley Healthcare System, 1310 24th Avenue South, Nashville, TN 37212, and Herbert Meltzer, MD, Psychiatry, Vanderbilt University, 1450 24th Avenue South, Nashville, TN 37212.

The purpose of this study was to collect data on compliance with atypical antipsychotic medications compared to typical antipsychotics and conduct a randomized, comparison group (i.e., usual care) study to assess the clinical effectiveness of a Telephone Medical Management (TMM) for veterans with schizophrenia. Non-compliance with typical neuroleptic drugs is well established as a major factor in relapse. Up to 80 percent of persons with psychoses do not adequately adhere to their medication treatment program (Corrigan, Liberman, and Engel, 1990) and non-compliance is a major contributing factor in rehospitalization (Frankle, Breeling, and Goldman). Two hundred patients with schizophrenia and schizoaffective disorder were recruited at the Alvin C. York VA Medical Center. Patients were randomized, in equal numbers, to either the TMM condition or non-TMM condition. TMM was found to increase the effectiveness and compliance of both typical and atypical antipsychotic drugs. Recall memory was observed to be a predictor of noncompliance. Noncompliance was found to be inversely related to efficacy and extrapyramidal symtoms. Compliance with atypical antipsychotic drugs was better than that with typical neuroleptics due to enhanced cognitive abilities, increased efficacy, and decreased side effects.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to: (
• List the five most important predictors of post-treatment compliance with atypical antipsychotic drugs. (
• Articulate a rationale for the development and utilization of a telephone medication management [TMM] program. (
• Develop a plan for the implementation of a telephone medication management [TMM] program for patients with schizophrenia and schizoaffective disorder.

Keywords: Sever Mental Illness, Management and Sustainability

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.