It has remained unclear what factors relate to primary nonadherence to antipsychotic treatment and whether specific agents and routes of administration differ in how patients adhere to them. We collected electronic prescriptions and their dispensings from the Finnish electronic prescription database for 29 956 patients with schizophrenia prescribed antipsychotics via electronic prescription during 2015–2016. We defined primary nonadherence as being prescribed an antipsychotic, which was not dispensed from the pharmacy within one year from prescription. Using logistic regression, we analyzed whether several sociodemographic and clinical factors related to nonadherence. We found that 31.7% (N = 9506) of the patients demonstrated primary nonadherence to any of their prescribed antipsychotics. We found that young age (OR = 1.77, 95%CI = 1.59–1.96), concomitant benzodiazepines (OR = 1.47, 95%CI = 1.40–1.55) and mood stabilizers (OR = 1.29, 95%CI = 1.21–1.36), substance abuse (OR = 1.26 95%CI = 1.19–1.35), previous suicide attempt (OR = 1.21, 95%CI = 1.11–1.31), diabetes (OR = 1.15, 95%CI = 1.06–1.25), asthma/COPD (OR = 1.14, 95%CI = 1.04–1.25), and cardiovascular disease (OR = 1.12, 95%CI = 1.05–1.19), were related to primary nonadherence to antipsychotic treatment. Patients using clozapine showed the lowest nonadherence (4.77%, 95%CI = 4.66–4.89), and patients using long-acting injectables were more adherent to treatment (7.27%, 95%CI = 6.85–7.71) when compared to respective oral agents (10.26%, 95%CI = 10.02–10.49). These results suggest that selection between different pharmacological agents and routes of administration while taking into account patients’ concomitant medications (benzodiazepines in particular) and comorbidities play a key role in primary nonadherence to antipsychotic treatment.

中文翻译：

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精神分裂症患者对抗精神病药物治疗的原发性不依从性

目前尚不清楚哪些因素与抗精神病药物治疗的原发性不依从性有关，以及特定药物和给药途径在患者依从性方面是否存在差异。我们从芬兰电子处方数据库中收集了 29956 名精神分裂症患者在 2015-2016 年间通过电子处方开具抗精神病药物的电子处方及其配药情况。我们将原发性不依从性定义为处方了一种抗精神病药物，但该药物在处方后一年内未从药房分发。使用逻辑回归，我们分析了几个社会人口统计学和临床​​因素是否与不依从性有关。我们发现 31.7% (N = 9506) 的患者表现出对任何处方抗精神病药物的原发性不依从性。我们发现年轻时 (OR = 1.77, 95%CI = 1.59–1.96), 同时使用苯二氮卓类药物 (OR = 1.47, 95%CI = 1.40–1.55) 和情绪稳定剂 (OR = 1.29, 95%CI = 1.21–1.36)，药物滥用 (OR = 1.26 95%CI = 1.19–1.35)，既往自杀未遂(OR = 1.21, 95%CI = 1.11–1.31)、糖尿病 (OR = 1.15, 95%CI = 1.06–1.25)、哮喘/COPD (OR = 1.14, 95%CI = 1.04–1.25) 和心血管疾病 ( OR = 1.12, 95%CI = 1.05–1.19)，与抗精神病药物治疗的原发性不依从性有关。与各自的口服药物相比，使用氯氮平的患者的不依从性最低（4.77%，95%CI = 4.66–4.89），使用长效注射剂的患者对治疗的依从性更高（7.27%，95%CI = 6.85–7.71） (10.26%, 95%CI = 10.02–10.49)。