By Sara Freeman, medwireNews Reporter
Quitting cannabis appears to improve medication adherence in the long-term among patients admitted for first-episode psychosis (FEP), researchers have found.
They also report that this may be particularly important in patients who are hospitalized involuntarily.
â€œOur results suggest that cannabis use and its withdrawal could be a mediator of adherence in FEP patients,â€ say Ana GonzÃ¡lez-Pinto (Hospital Santiago, Vitoria, Spain) and colleagues in BMC Psychiatry. The researchers note that stopping using cannabis might improve medication adherence and potentially clinical and functional outcomes.
GonzÃ¡lez-Pinto and colleagues studied 98 individuals, aged an average of 29.8 years, admitted to a general hospital psychiatric ward for FEP. Patients were assessed via a battery of psychiatric tests at admission and at annual follow-up over an 8-year period.
Adherence was determined by self-report via the Moriskyâ€“Green test. At baseline, 73% of patients were identified as having bad adherence to their medication, including all of those who had been involuntarily admitted and 46.7% of those using cannabis.
The percentage of patients using alcohol, cannabis, or other substances decreased throughout the study to 57%, 29%, and 16%, respectively, by the end of the 8-year period. At the same time, the percentage of patients with good adherence increased from 26% at baseline to 51%. Of these patients, only 12.8% continued to use cannabis.
According to multiple logistic regression analysis, patients who never used or stopped using cannabis during follow-up were 8.79 times more likely to improve from bad to good adherence, after taking into account type of first admission.
Similarly, treatment adherence improved 5.65-fold among patients who were admitted involuntarily rather than voluntarily, after accounting for cannabis use.
â€œOur findings imply that FEP patients with coexisting cannabis use are more likely to be nonadherent to medication and should be a target for interventions aimed at both stopping substance use and improving adherence,â€ say GonzÃ¡lez-Pinto and colleagues.
â€œSuch efforts include involuntary admissions and may result in improved clinical outcomes and patient functioning although further studies are needed.â€
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