Interventions to improve adherence to psychotropic medication in clients of Asian descent: A systematic review

Fewer than half of Asian Americans prescribed psychotropic medication actually adhere to their medications. Poor psychotropic medication adherence among Asian Americans might be influenced by cultural beliefs about medication, mental illness, and stigma surrounding mental disorders, but the data are limited. Studies in Asian populations, whose belief systems are shared by many Asian American groups, may help broaden our understanding of medication adherence in Asian Americans. The purpose of this article is to synthesize existing research on interventions that might contribute to improved adherence to psychotropic medication among psychiatric patients of Asian descent. Searches of PubMed and PsycINFO for relevant articles published between 1960 and October 2010 yielded 1,520 potentially relevant studies. Nine intervention studies met the inclusion criteria for this systematic review. Most successful interventions used variations on psychoeducation that included both patients and family caregivers. Even in the absence of significant changes to adherence, patients often showed clinical improvement. Improvements in knowledge and attitude among patients and family caregivers coincided with clinical improvement. Findings highlight the effects of caregiver and patient causal beliefs on adherence outcome. Implications for adherence to psychotropic medication interventions among Asian Americans are discussed.