Improving Medication Adherence Among People With Schizophrenia Through the Use of 2-way Pagers

Schizophrenia is a life-long brain disorder affecting approximately 1 percent of Americans
each year. Schizophrenia can be extremely disabling, causing people to hear voices,
experience paranoia or hallucinations, and believe that others are controlling their
thoughts. Many people with schizophrenia have difficulty with remembering their scheduled
doctor's appointments and with taking their medication on time because of their mental
illness. Many approved medications for schizophrenia must be taken several times a day and
side effects such as drowsiness, dizziness, and even weight gain can deter a person from
consistently taking their medication on time. Therefore, this study will determine whether a
2-way pager will help people with schizophrenia to remember their doctor's appointments and
to take their medication on time.

Participants in this open-label study will first complete several written tests to assess
skills such as memory, attention, and problem solving. Participants will also be asked
questions regarding their current symptoms and medication regimen. Participants will then be
randomly assigned to receive either treatment as usual or treatment as usual and a 2-way
pager for 6 months. Participants who receive a 2-way pager will attend approximately four
information sessions. During these sessions, participants will learn how to program the pager
and use a specially designed medication bottle cap that will record the number of bottle
openings and the date and time of each opening. At designated times, the pager will vibrate
or beep, alerting participants to take their medication or attend a scheduled appointment.
All participants will meet weekly with a staff member for the first month and then once a
month for the remaining 5 months to complete several brief questionnaires on pager use,
assess medication adherence, and discuss any symptoms experienced within the past week or
month. Participants will be required to bring their medication to each meeting to ensure
compliance.

Inclusion Criteria:

- Meets DSM-IV criteria for schizophrenia or schizoaffective disorder

- Admitted to the Zucker Hillside Hospital for exacerbation of illness

- Speaks English

Exclusion Criteria:

- Presence of severe visual or motor impairments

- Mental retardation

- Neurologic disorder that may impact functioning such as seizures or vascular,
neoplastic, traumatic, or infectious disorders affecting the brain

- Prescribed a psychotropic drug in depot form

- After hospital discharge, a living or treatment situation that includes dispensing of
full medication regimen