Mediating effect of the motivation for medication use on disease management and medication adherence among community-dwelling patients with schizophrenia

Abstract

Background: Nearly half of patients with schizophrenia do not adhere to the long-term medical treatment needed to manage their disease. Programs to promote medication adherence include promotion of motivation as a critical element to influence task performance. Purpose: This study investigated the mediating effect of motivation for medication use on disease management and medication adherence in schizophrenia. Methods: This cross-sectional, descriptive correlational study enrolled a convenience sample of 373 community-dwelling patients with schizophrenia in the northern and central regions of Taiwan. Data were collected with questionnaires and a series of validated assessment tools. Hierarchical regression was used to analyze the mediating effect of motivation for medication use on disease management and medication adherence. Results: The medication adherence rate of the patients was 47.2%. The mediating effect of motivation for medication use on therapeutic alliance and medication adherence was 50%, whereas that on insight and medication adherence was 41% and that on medical social support and medication adherence was 72%. Conclusion: Developing a medication motivation care model may be more effective than promoting therapeutic alliance, insight, or medical social support for promoting medication adherence. It also had greater impact on preventing relapses of community-dwelling patients with schizophrenia.