The Long Term Effectiveness of Telephone Intervention Problem Solving (TIPS)

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Project Details -
Completed

Medication nonadherence is the strongest predictor of symptom relapse among people who have schizophrenia spectrum disorders (SSDs). Relapse accounts for most of the nearly $80 billion annual cost of treating SSD in the United States. Research indicates that problem-solving interventions are among the most effective treatments to improve adherence and reduce costs; however, problem-solving is seldom offered as a strategy because of the high cost and time constraints.

This project built off of a pilot study of the “Telephone Intervention Problem Solving” (TIPS) intervention, which aims to improve medication adherence for patients with SSDs. TIPS incorporates several features shown to be successful such as individualized treatment, frequent patient contact, and concrete problem-solving strategies. The pilot study concluded that TIPS was a feasible and efficient strategy for improving adherence; however, one-third of eligible participants were excluded from the study because they did not have access to a home telephone. This followup study delivered TIPS through cellular phones to expand access to the intervention.

The specific aims of this project were as follows:

  • Examine effect of TIPS upon serum medication level, pill count adherence, and scores on the Medication Adherence Rating Scale (MARS). 
  • Examine effect of TIPS on Medication Adherence Self Efficacy (MASES) scores. 
  • Examine the effect of TIPS upon Positive and Negative Syndrome Scale (PANSS) scores. 

A randomized controlled trial assigned study participants to the TIPS intervention or usual care. Analyses conducted 6 months into the study did not identify improvements in medication adherence for the TIPS study arm as measured by pill counts and serum medication levels. Analysis of data collected 9 months into the study was ongoing at the time the final report was submitted. Future research on TIPS will consider strategies for reducing participant drop out and alternative measures of adherence, such as pharmacy refill records.