This study will determine whether Medication Adherence Therapy (MAT) can improve medication
adherence and lower the risk of rehospitalization in older patients with psychosis.
Psychoses are among the most common and serious psychiatric disorders. Currently, the most
effective treatment for psychoses involves the use of antipsychotic or neuroleptic
medications. Unfortunately, pharmacologic regimens often do not achieve their goals because
of poor medication adherence. Nonadherence to antipsychotic treatment is a considerable
public health problem that leads to myriad clinical and economic burdens, including
psychotic relapse, increased clinic and emergency room visits, and rehospitalization.
Participants in this study are randomly assigned to receive either MAT or supportive
treatment for 12 weeks. MAT is given in 15 sessions and consists of motivational
interviewing, education, and social skills and behavior modification. Individual MAT
sessions are held in Weeks 1 and 12; small group sessions take place in Weeks 2 through 11.
Three monthly booster group sessions begin in Week 16. Participants are assessed at baseline
and at 3, 6, and 12 months. Medication adherence, psychopathology, quality of life,
medication side effects, health beliefs, and functioning are assessed.
- DSM-IV criteria for schizophrenia or schizoaffective disorder
- Outpatient status at the time of enrollment
- Currently prescribed maintenance treatment with antipsychotic medication (typical or
atypical, oral or depot)
Jonathan Lacro, PharmD
VA San Diego Healthcare System & University of California, San Diego