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Electronic Letters to:

REVIEW ARTICLES: MICHELA NOSÉ, CORRADO BARBUI, RICHARD GRAY, and MICHELE TANSELLA Clinical interventions for treatment non-adherence in psychosis: meta-analysis The British Journal of Psychiatry 2003; 183: 197-206 [Abstract] [Full text] [PDF]

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Electronic letters published:

Long term benefit of reminder letters in reducing treatment non-adherence

C Feroz-Nainar   (8 April 2005)

Long term benefit of reminder letters in reducing treatment non-adherence 8 April 2005
C Feroz-Nainar, Acting Consultant in Learning Disability Psychiatry South Birmingham PCT Send letter to journal: Re: Long term benefit of reminder letters in reducing treatment non-adherence doctorferoz{at}yahoo.co.uk C Feroz-Nainar	As the authors rightly point out there is a paucity of data with regard to the long term effectiveness of interventions to reduce treatment non-adherence. We conducted a complete audit project at the learning disability clinics in South Birmingham to reduce the treatment non-adherence i.e. to reduce the missed appointments at the clinics (Feroz-Nainar et al, 2005). The sample size was 201. The non-adherence rate was high among the new referrals when compared to the follow-up appointments (61% vs 17%) and the difference was highly significant. The intervention employed was sending reminder letters 3 days prior to the new appointments and this brought down the non-adherence rate significantly to 10%. A 2-year follow-up study to measure the long term benefit of the intervention revealed that the non-adherence rate increased to 37% however this was not statistically significant. This could have two possible explanations. As the sample size was small during the follow-up study the results may not have indicated a true reflection of the effectiveness of the intervention. Or it may mean that the intervention loses its effectiveness over time. Another approach would be to target interventions at the factors found to be associated with treatment non-adherence for example substance abuse, unemployment etc. (Nose et al, 2003). References 1.Feroz Nainar C, Meera Roy (2005) 'Non-attendance at learning disability out-patient clinics', e-letter published on the 8 Feb 2005 on the Psychiatric Bulletin website, http://pb.rcpsych.org/cgi/eletters/29/2/56 2.Nose et al, 'Clinical Interventions for treatment non-adherence in psychosis', British Journal of Psychiatry (2003); 183: 197-206.