Factors Affecting Clozapine Adherence in Patients With Schizophrenia: A Qualitative Study
10.4306/jknpa.2025.64.4.277
- Author:
Sung Moon CHOI
1
;
Myung Jae BAIK
;
Won Sub KANG
;
Ah Rah LEE
;
Jong Woo PAIK
;
Sang Min LEE
Author Information
1. Industry-Academic Cooperation Foundation, Kyung Hee University, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Korean Neuropsychiatric Association
2025;64(4):277-288
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:This study examined the psychosocial factors that influence the continuation of clozapine use among individuals with schizophrenia. This examination was conducted through indepth qualitative interviews.
Methods:Thirty-one adults diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) who had been taking Clozapine ® for at least 3 months were interviewed. Data were collected from May to October 2024 and analyzed using Braun and Clarke’s thematic analysis.
Results:Two overarching themes emerged: 1) transformation of perceptions and engagement with treatment, including initial resistance stemming from severe symptoms and lack of insight, experiences of coercive interventions, rebuilding trust in the mental health system, and evolving attitudes toward psychiatric medications; and 2) personal recovery and social support, encompassing coping with side effects, recognizing symptom improvement and renewed hope, and the pivotal roles of family and therapeutic alliance. Trust in healthcare providers and emotional support from family were central to sustained adherence to clozapine.
Conclusion:Sustained clozapine use in schizophrenia patients is influenced by intertwined psychological, relational, and contextual factors. Acceptance of treatment was supported by symptom improvement, family support, and trust in healthcare providers. These elements contributed to medication adherence and broader functional recovery. A person-centered, integrated approach is essential to promote continued use and long-term outcomes.
