# Virtual nurse support to enhance antipsychotic adherence in schizophrenia: A South African perspective

## TL;DR

A virtual nurse via text messages improved antipsychotic adherence and reduced relapses in schizophrenia patients in South Africa.

## Contribution

A novel virtual buddy intervention using psychiatric nurses to improve medication adherence in schizophrenia patients.

## Key findings

- Adherence improved from 60.8% to 83.51% post-intervention (p < 0.001).
- Obstacles like forgetfulness and side effects were reduced after the intervention.
- Relapse, rehospitalization, and employment loss decreased post-intervention.

## Abstract

Patients with schizophrenia rely on antipsychotic medication, with adherence being critical for symptom management. Poor adherence leads to relapse, disability and increased healthcare costs.

This study investigated the impact on antipsychotic adherence among schizophrenia patients on the introduction of an intervention utilising a psychiatric nurse as a virtual treatment buddy.

Participants were recruited from a psychiatric clinic in KwaZulu-Natal, South Africa.

This quantitative pre-test-post-test control group study recruited 117 schizophrenia patients. Participants were randomly assigned to an intervention group (n = 82) receiving daily text message support or a control group (n = 35) without support. Pre- and post-intervention questionnaires assessed medication adherence. The McNemar test compared medication cessation frequencies pre- and post-intervention. Pearson’s chi-squared test, factor analysis and linear regressions were employed to correlate variables. A p < 0.05 was deemed statistically significant.

Adherence improved from 60.8% to 83.51% post-intervention (p < 0.001). Obstacles to adherence, including inadequate disease knowledge, treatment duration, side effects, misunderstanding instructions and forgetfulness, were reduced post-intervention. Additionally, symptom relapse, rehospitalisation, specialist referrals, the need for more potent medication and employment loss decreased post-intervention.

Virtual buddy support has demonstrated promise in improving medication adherence and minimising adverse effects of discontinuation among schizophrenia patients.

This study contributes a method to improving antipsychotic adherence and reducing negative outcomes in schizophrenia patients by emphasising personalised support, education and collaborative care among healthcare providers and support systems.