The long term effectiveness of Telephone Intervention Problem Solving (TIPS)

University Of Tennessee Knoxville, Knoxville TN

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Abstract

DESCRIPTION (provided by applicant): Medication non adherence is the strongest predictor of symptom relapse in persons with schizophrenia spectrum disorders (SSDs = schizophrenia and schizoaffective disorder), accounting for most of the nearly $80 billion annual cost of treating these illnesses in the United States. A large body of research shows that problem-solving interventions are among the most effective treatments for improving adherence and reducing treatment costs, but these interventions are seldom offered due to budget and personnel constraints. In a series of studies we have piloted Telephone Intervention - Problem Solving (TIPS) and found this provider initiated, telephone based intervention protocol to be a feasible, time-efficient way to provide problem solving interventions. TIPS significantly improved medication adherence compared to usual care over 3 months, but one third of eligible persons were excluded from our pilot studies because they lacked or lost home telephone access. In this follow up study based upon Ajzen's Theory of Planned Behavior, we will test the effect of cellular telephone delivered TIPS compared to treatment as usual (TAU) on medication adherence, medication attitudes and symptom management over 9 months. Hypotheses: Persons receiving TIPS will have: 1-higher blood medication levels and higher pill count adherence 2-higher medication attitudes and higher medication adherence self efficacy 3-lower psychiatric symptom scores than controls throughout the 9- month study