Schizophrenia patients who perform poorly on certain cognitive tests are less likely to adhere to their correct course of medication compared to the patients who perform well on cognitive tests.

Schizophrenia

These are the findings of a research study performed recently by Dr. Walter Heinrichs and the colleague researchers at the “York University, Toronto, Canada”. Dr. Walter Heinrichs and his research team found that patients with deficits in word recognition and pronunciation, auditory working memory, and verbal learning showed poor medication competence in simulated tests. This study report with all the findings has been published recently in the journal “Psychiatry Research”.

According to the findings of this study, medication competence refers to a patient’s knowledge and ability to self-administer oral medication.” It is necessary for actual medication adherence, although patient factors such as symptom severity and subjective drug response also play an important role”, Dr Walter Heinrichs and colleagues explain.

Preliminary evidence had already suggested that global cognitive impairment contributes to poor medication competence.

In order to investigate further, the researchers recruited 147 patients diagnosed with schizophrenia or schizoaffective disorder who belonged to the age group 21-65 years. These Patients were interviewed to assess psychopathology, global cognition, and medication competence.

In this study, ‘Medication Competence’ was measured using the “Medication Management Ability Assessment (MMAA)”. Patients were presented with four mock medications with dosages and administration instructions printed on the bottle labels. They were then asked how they would take their regimen of medication throughout the day, and were scored out of a possible maximum of 25.

According to the study published in the journal “Psychiatry Research”, MMAA scores varied markedly from 3 to 25, with some patients highly proficient in medication competence and others severely defective.

Patients who scored highly on reading level, vocabulary, matrix reasoning, symbol search, letter-number sequencing, and verbal learning had higher MMAA scores. Positive and negative symptom severity did not, however, correlate with MMAA score.

“The results confirm the unique contribution of cognitive performance in predicting medication competence,” said Dr. Walter Heinrichs.

The researchers speculate that therapy to improve memory could aid medication adherence, but they also caution that adherence behavior is complex and requires different approaches.

Dr. Walter Heinrichs and his research team concluded that, “It seems likely that a combination of cognitive enhancement and training in specific competencies as well as strategies to address subjective experience and symptoms holds the greatest promise in terms of rehabilitation”.

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