Evaluating the effectiveness of virtual buddy support to improve treatment adherence for patients suffering from schizophrenia in KwaZulu-Natal: a model of care

Abstract

Background: Psychiatric patients that are suffering from schizophrenia disorder are prescribed antipsychotic medications which are the first line treatment strategy for this disorder. Research has revealed that schizophrenic patients struggle to adhere to their prescribed medication. Interventions to promote adherence to these medications are required. One intervention suggested, which is new in psychiatry, is the use of treatment buddy services. This study investigated the effectiveness of virtual treatment buddy support in improving adherence to antipsychotic medications amongst patient diagnosed with schizophrenia disorder. Methods: A mixed methods approach was utilized. A total of 117 schizophrenic patients were recruited from a selected psychiatric clinic in KwaZulu-Natal to participate in this study. From this cohort of participants, 82 were allocated to an intervention group which was provided with treatment buddy support and the remaining 35 formed the control group and did not receive any treatment buddy support. A research assistant was employed to act as a treatment buddy; she sent text message reminders to the participants on a daily basis between 6am and 7am for a period of six months. She also attended to telephonic queries made by participants. Quantitative questionnaires and qualitative interviews were used to collect data. Quantitative data was analyzed using SPSS Version 20.0, and qualitative data was analyzed using thematic analysis. Results: The implementation of treatment buddy support improved adherence to antipsychotic medication from 60.7% pre-intervention to 86.1% post intervention. Some of the reported obstacles to antipsychotic adherence included long duration of treatment (50%), having no cure for the disorder (39.3%), medication side effects (47.7%), not understanding the instructions regarding taking of medications (40.9%) and experience of odd feelings while continuing with treatment (45.5%). Themes that emanated from qualitative interviews supported the quantitative findings that virtual treatment “buddy services” had improved adherence to antipsychotic drugs. Other themes identified, were improved support from clinic, and alleviation of other schizophrenia related problems. The treatment buddy services were also supported by nurses and the research assistant. Conclusion: Implementation of treatment buddy support to patients suffering from schizophrenia was accepted by the patients and nurses and have improved adherence to antipsychotic medications. Implementing treatment buddies can benefit health care institutions, communities, and the health care system at large.