Discussion
Medication adherence is a well recognized issue
with most treated disorders and types of medication.
When the key behaviours of a disorder
include disorganization, forgetfulness, distractibility
and lack of attention, it may potentially be
more of an issue. The use of a patient support
programme offered through the initial stages of
treatment may assist in addressing issues of nonadherence.
Patients enrolled into the SSS reported
higher rates of noncontinuous compliance during
the first 12 weeks of therapy than comparative
rates reported in naturalistic, retrospective data.
The authors are unaware of any additional data
that can be cited on discontinuation rates at 12
weeks in naturalistic cohorts.
A feature of the SSS which may be of particular
benefit to carers and patients is the employment
of qualified dual-trained nurses (registered general
nurse/registered mental nurse), trained in
both mental illness and the use of psychological
techniques to deliver ongoing support.
Adherence to medication should lead to improved
outcomes for those patients. Our service evaluation
data are both descriptive and preliminary;
further research may be necessary to evaluate the
degree to which the SSS is associated with low
discontinuation rates and subsequent improvement
in clinical outcome. Research into the
efficacy of patient support programmes is now
becoming feasible [A’Campo et al. 2011].
There are several limitations of this analysis that
need to be factored into any interpretation. There
was no randomization and the two compared populations
are likely to be different. No further information
is available on the Cegedim population.
This analysis measured adherence as the number
of patients in the SSS who were taking atomoxetine
at week 12. However, patients may have
stopped and restarted their medication prior to
week 12 and these data are unknown. There was
no assessment of the correlation between frequency
of contact and continuation, thus it is not
possible to factor in the importance of frequency