OBJECTIVES:The main objectives of the Adherence in Schizophrenia (ADHES) survey in the Philippines were to: (1) describe the insights of Filipino psychiatrists on the level of adherence to treatment of patients with schizophrenia; and (2) to identify possible main challenges for treatment adherence in schizophrenia.
METHODOLOGY:The 2012 ADHES Asia Pacific (APAC) survey was a questionnaire-based survey with 4,661responding psychiatrists (24% of recipients) in 13 countries in the Asia-Pacific region, which was administered from January 2012 to April 2012. In the Philippines (n=17), the survey was conducted between March and April 2012 and distributed to psychiatrists by Janssen personnel. The 20-item questionnaire was devised to ascertain psychiatrists' preferred methods of assessing perceptions of the levels of adherence, reasons for non-adherence to treatment in schizophrenia patients, their perceptions of the levels of adherence, reasons for non-adherence and strategies to improve adherence. Gender, age and practice setting of the psychiatrists were also collected for analysis.
RESULTS:A total of 71 psychiatrists responded to the ADHES Survey in the Philippines. The most common approaches used by the psychiatrists in assessing adherence to prescribed doses were asking an informant (e.g. relative, friend, caregiver) (96%) and asking the patient directly (94%). About 48% of the patients were "fully-adherent" or took at least 90% of prescribed doses as assessed by the psychiatrists who were included in the survey. Meanwhile, 23% of the patients were "non-adherent" or took 30% of prescribed doses. According to the psychiatrists, the most were lack of insight (28%) and cognitive impairment (24%). However, the most common reason for stopping medication among the respondents' patients was due to insufficient efficacy of the antipsychotic or having experienced psychotic symptoms with the medication they are taking (30%). Lastly, the most preferred pharmacological strategies used by the respondents to address an adherence problem in patients with schizophrenia were switching to a long-acting anti psychotic medication (27%) and switching to a different oral antipsychotic (23%).
CONCLUSION:Partial or non-compliance to medication is a serious issue in schizophrenia, and insight into illness in schizophrenia, and insight into illness in schizophrenia is the most important reason for treatment non-adherence. Thu, there is a need to continuously assess the level of insight in patients with schizophrenia and institute more pro-active interventions such as direct-observation treatment for oral medications or long-acting injectable antipsychotics. The more wide-spread use objective assessments of medication  compliance can also be explored.