Customized Adherence Enhancement Plus Long-acting Injectable Antipsychotic

Psychotropic medications are a cornerstone of treatment for individuals with schizophrenia
and schizoaffective disorder, however rates of full or partial non-adherence can exceed 60%.
Inadequate adherence is associated with poor outcomes such as relapse, homelessness,
hospitalization, and increased health care costs. Studies have shown a direct correlation
between non-adherence and rates of relapse in schizophrenia; on average, non-adherent
patients have a risk of relapse that is 3.7 times greater than their adherent counterparts.
A major obstacle to good outcomes in the maintenance treatment of patients with severe
mental illness is difficulty with medication routines on an on-going basis. For this reason,
long-acting injectable antipsychotic medication is a particularly attractive treatment
option for populations with schizophrenia and schizoaffective disorder, although it is
unlikely that medication treatment alone is likely to modify long-term attitudes and
behaviors.

This prospective study is a pilot analysis of a combined approach which merges a
psychosocial intervention to optimize treatment attitudes towards psychotropic medication
(CAE) and long-acting injectable antipsychotic medication (L) in recently homeless
individuals with schizophrenia or schizoaffective disorder who are known to have on-going
difficulties with treatment non-adherence. It is expected that this combined approach
(CAE-L) will improve illness outcomes among the most vulnerable of populations with
schizophrenia or schizoaffective disorder.