People with schizophrenia also have cognitive problems which, as well as generally making life more difficult, can also affect how well they adhere to their medication. Cognitive adaptation training (CAT) is an intervention that uses compensatory strategies and supports such as pill containers with alarms, organization of belongings and activity checklists to prompt and sequence adaptive behaviours in an individual's home environment. A Texan study of 95 outpatients with schizophrenia allocated them to three groups: full-CAT which focused on many different aspects of looking after oneself such as grooming, care of living quarters, leisure skills, social and role performance and medication adherence; pharm-CAT which just concentrated on medication adherence and treatment as usual. The treatment lasted for 9 months and participants were followed for 6 months after the withdrawal of home visits. Both full-CAT and pharm-CAT were superior to treatment as usual for improving adherence to medication even after the home visits were withdrawn. Full-CAT had a greater impact on outcome compared to the other two groups but only as long as the home visits were being made. Survival time to relapse was significantly longer in both the full-CAT and pharm-CAT groups compared to treatment as usual.
Velligan, Dawn I. ... [et al] - The use of individually tailored environmental supports to improve medication adherence and outcomes Schizophrenia Bulletin May 2008, 34(3), 483-493