ReviewPatient preference and adherence2017
Why do psychiatric patients stop antipsychotic medication? A systematic review of reasons for nonadherence to medication in patients with serious mental illness.
Review in Patient preference and adherence, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 155 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
155 citing papers in PubMed, 7 syntheses or guidelines pooled it, 313 citations in OpenAlex.
- Systematic review and network meta-analysis of the efficacy, safety and tolerability of xanomeline plus trospium chloride compared with eight oral antipsychotics for the acute treatment of schizophrenia.Journal of comparative effectiveness research · 2026Pooled it
- Psychosocial and Demographic Factors Associated with Physical Multimorbidity in Severe Mental Illness: A Systematic Review.Schizophrenia bulletin · 2026Pooled it
- Informing the development of a decision aid: Expectations and wishes from service users and psychiatrists towards a decision aid for antipsychotics in the inpatient setting.Health expectations : an international journal of public participation in health care and health policy · 2023Pooled it
- Efficacy of Transcranial Direct Current Stimulation to Improve Insight in Patients With Schizophrenia: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Schizophrenia bulletin · 2022Pooled it
- Systematic Literature Review of Text Messaging Interventions to Promote Medication Adherence Among People With Serious Mental Illness.Psychiatric services (Washington, D.C.) · 2022Pooled it
- Can incentives improve antipsychotic adherence in major mental illness? A mixed-methods systematic review.BMJ open · 2022Pooled it
- Adherence to Oral Antipsychotics Measured by Electronic Adherence Monitoring in Schizophrenia: A Systematic Review and Meta-analysis.CNS drugs · 2020Pooled it
- Positive symptoms and medication adherence in response to oral versus long-acting injectable risperidone in black, latino, and white first-episode psychosis patients.Schizophrenia research · 2025Trial
- Randomized Laboratory Study of Single-Dose Cannabis, Dronabinol, and Placebo in Patients With Schizophrenia and Cannabis Use Disorder.Schizophrenia bulletin · 2025Trial
- Simple Mobile technology health management tool for people with severe mental illness: a randomised controlled feasibility trial.BMC psychiatry · 2021Trial
- The Effects of Bi-Anodal tDCS Over the Prefrontal Cortex Regions With Extracephalic Reference Placement on Insight Levels and Cardio-Respiratory and Autonomic Functions in Schizophrenia Patients and Exploratory Biomarker Analyses for Treatment Response.The international journal of neuropsychopharmacology · 2021Trial
- Measuring adherence to antipsychotic medications for schizophrenia: Concordance and validity among a community sample in rural China.Schizophrenia research · 2018Trial
- Homeless women with schizophrenia reported lower adherence to their medication than men: results from the French Housing First experience.Social psychiatry and psychiatric epidemiology · 2017Trial
- Integrated Psychological-Behavioral Predictive Model Using Explainable Machine Learning.Healthcare (Basel, Switzerland) · 2026Article
- A Claims Data-Based Comparison of Treatment Continuation between Aripiprazole Once-monthly and Paliperidone Palmitate in Routine Practice.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026Article
- Article
- Effectiveness of M-Health Interventions to Improve Medication Adherence in People with Schizophrenia Spectrum Disorder: A Systematic Review.Nursing reports (Pavia, Italy) · 2026Review
- Advancing Personalized Medicine in Psychiatry: A Descriptive Pilot Study Integrating Pharmacogenetics and Pharmacokinetics in Long-Acting Antipsychotic Treatment.Pharmaceutics · 2026Article
- The demand-side challenges in public mental health: A narrative study in a rural South Indian community.Indian journal of psychiatry · 2026Article
- Evaluating the Implementation of a Medication Dispensing Telehealth Platform in Community Behavioral Health Settings.Community mental health journal · 2026Article
95 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntipsychotic medication reduces the severity of serious mental illness (SMI) and improves patient outcomes only when medicines were taken as prescribed. Nonadherence to the treatment of SMI increases the risk of relapse and hospitalization and reduces the quality of life. It is necessary to understand the factors influencing nonadherence to medication in order to identify appropriate interventions. This systematic review assessed the published evidence on modifiable reasons for nonadherence to antipsychotic medication in patients with SMI.
methodsArticles published between January 1, 2005, and September 10, 2015, were searched on MEDLINE through PubMed. Abstracts were independently screened by 2 randomly assigned authors for inclusion, and disagreement was resolved by another author. Selected full-text articles were divided among all authors for review.
resultsA qualitative analysis of data from 36 articles identified 11 categories of reasons for nonadherence. Poor insight was identified as a reason for nonadherence in 55.6% (20/36) of studies, followed by substance abuse (36.1%, 13/36), a negative attitude toward medication (30.5%, 11/36), medication side effects (27.8%, 10/36), and cognitive impairments (13.4%, 7/36). A key reason directly associated with intentional nonadherence was a negative attitude toward medication, a mediator of effects of insight and therapeutic alliance. Substance abuse was the only reason consistently associated with unintentional nonadherence, regardless of type and stage of SMI. DISCUSSION: Although adherence research is inherently biased because of numerous methodological limitations and specific reasons under investigation, reasons for nonadherence consistently identified as significant across studies likely reflect valid existing associations with important clinical implications.
conclusionThis systematic review suggests that a negative attitude toward medication and substance abuse are consistent reasons for nonadherence to antipsychotic medication among people with SMI. Adherence enhancement approaches that specifically target these reasons may improve adherence in a high-risk group. However, it is also important to identify drivers of poor adherence specific to each patient in selecting and implementing intervention strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.