Towards the improvement of compliance: The significance of psycho-education and new antipsychotic drugs

Effective pharmacological, psychosocial and other kinds of treatment are now available for schizophrenia. Often, however, neither acute nor long-term treatment can be properly applied because of insufficient compliance by both patients and doctors. Patient noncompliance is as high as 50% under outpatient conditions; potential reasons may be either illness-related (e.g. lack of insight or idiosyncratic concepts of the illness or its treatment), drug-related (e.g. intolerable side effects) or related to inadequate treatment management (e.g. insufficient information or lack of environmental support). Non-compliance by doctors is partly due to limited adherence to treatment guidelines. To improve both patient and doctor compliance, the use of educational tools for professional health-care providers, patients and families should be generally enforced. New antipsychotics with a better risk-benefit profile with respect to clinical efficacy and side effects will probably help to overcome drug-related non-compliance.