Predicting compliance with neuroleptic medication : developing clinically useful scales

The aim of the study was to determine the attitudes of patients towards neuroleptic medication in relation to compliance, in order to develop a measure that will allow clinicians to predict likely compliance difficulties.;A catchment area sample of 106 adult schizophrenics completed three new self-report measures, a rating scale of attitudes to medication (Drug Attitudes Scale - DAS), a scale based on the theory of planned behaviour (Theory of Planned Behaviour Scale - TPB) and a measure of compliance with medication (Drug Behaviour Scale - DBS). Keyworkers rated compliance, using an established measure (the Kemp Scale).;Three reliable variables from these scales were renamed positive, negative and conditional positive attitude and together named the Drug Compliance and Attitude Scale (DCAS). The DCAS predicted both keyworker (Kemp) and self-report (DBS) measures of compliance. The DCAS had modest concurrent validity and was superior in predictive power to the most popular established scale.;The non-compliance reported by patients was found to be mostly because they changed the time they took the medication rather than because of changing dosage and involved increasing as well as reducing frequency. Reasons for deviation from prescription included active manipulation of subjective state as well as passive non-compliance. It has been shown that compliance with neuroleptic regimes is a complex set of behaviours which involves more than simply taking or not taking medication. Future research on enhancing compliance among this patient group will need to consider the complex nature of both attitudes to medication and behavioural responses.;Clinical implications of the study include the use of the DCAS to enhance compliance, to identify those patients for whom the medication may not be effective and to evaluate treatments combining drug and psychological interventions.