Effect of a Telephone Intervention on Measures of Psychiatric and Nonpsychiatric Medication Adherence in Outpatients With Schizophrenia Spectrum Disorders.

Telephone intervention may address the need for problem-solving interventions to improve medication adherence in patients with schizophrenia spectrum disorders (SSDs). The current randomized controlled trial examined the effect of weekly telephone intervention problem solving (TIPS) on quantitative measures of psychiatric and nonpsychiatric medication adherence over 6 months in 105 stable outpatients with SSDs. Independent samples t test revealed no significant differences in psychiatric or nonpsychiatric pill count adherence between groups at 6 months; however, 54.7% of experimental participants versus 32.7% of controls had serum antipsychotic levels within therapeutic range at 6 months (χ2 = 5.2, df = 1, p = 0.023). The current study extends the literature on adherence in patients with SSDs by describing a clinical sample of stable outpatients over 6 months and examining adherence to psychiatric and nonpsychiatric medications. [Journal of Psychosocial Nursing and Mental Health Services, 55(1), 29-36.].

Descriptions and Correlates of Medication Adherence, Attitudes, and Self-Efficacy in Outpatients With Schizophrenia Spectrum Disorders (SSDs).

The problem of medication adherence in schizophrenia spectrum disorders (SSDs) has challenged researchers and clinicians for decades. Few investigations have examined non-psychiatric adherence in this group. We conducted a descriptive correlational investigation of adherence and related factors in 185 stable outpatients with SSDs. Fifty-seven percent of participants had antipsychotic medication levels within therapeutic range and 42% had levels below therapeutic range. Pill count percentage adherence to antipsychotic medications ranged from 0-100% with a mean of 70% and SD 34.9. Mean non-psychiatric medication adherence ranged from 0 to 100 with a mean of 61% and SD 31.8. The following characteristics were not significantly associated with adherence: age, diagnosis, gender, race, living arrangement, educational level, typical versus atypical antipsychotic medication. Level of symptoms was correlated negatively and significantly with self-reported medication adherence and medication adherence self-efficacy. Our next project will examine the effectiveness of a telephone-delivered intervention designed to support adherence in this group.

Effect of a Telephone Intervention Upon Self-Reported Medication Adherence and Self-Efficacy in Outpatients With Schizophrenia Spectrum Disorders (SSDs).

We conducted a randomized controlled trial to determine the effect of weekly telephone intervention upon self-reported medication adherence, medication adherence self efficacy, and symptom levels in 140 stable outpatients with SSDs for three months. To our knowledge, this is the first study examining medication adherence self efficacy in persons with SSDs. Study measures were administered in a private office by trained study staff immediately following the granting of informed consent, and again after three months. Participants ranged in age from 19-71 years with an average age of 46.1 years (SD 12.9). A majority were males (n = 80, 57.1%) with schizoaffective disorder (n = 94, 67.1%). Symptoms were lower and self-reported medication adherence was higher in experimental participant after three months, but differences were not statistically significant. Medication adherence self efficacy was essentially unchanged over the three month follow up period. This study extends the literature on adherence in SSDs by describing a clinic-based sample of stable outpatients, and is the first investigation to measure medication adherence self efficacy in this group. Our next project will examine the effectiveness of TIPS upon objectively measured medication adherence in this group over 6 months of follow up.

A comparison of telephone and texting interventions for persons with schizophrenia spectrum disorders.

Problem-solving interventions are not routinely offered to persons with schizophrenia spectrum disorders (SSDs). Telephone calls and text messages are potential avenues to offer problem solving support. This study compared the effect of telephone calls only, text messages only, and both telephone calls and text messages on individuals' symptoms and medication adherence. Thirty outpatient participants with SSDs were randomly assigned to weekly telephone calls, daily text messages, or both for three months. Participants received monthly in-home pill counts and symptom assessments. Repeated measures ANOVA was significant (F (4,26) = 4.2, p = 0.005) for symptom scores. Further work with larger, more diverse, samples is needed.

Inhibition of novel human-HPV hybrid ecDNA enhancers reduces oncogene expression and tumor growth in oropharyngeal cancer.

Extrachromosomal circular DNA (ecDNA) have been found in most types of human cancers, and ecDNA incorporating viral genomes has recently been described, specifically in human papillomavirus (HPV)-mediated oropharyngeal cancer (OPC). However, the molecular mechanisms of human-viral hybrid ecDNA (hybrid ecDNA) for carcinogenesis remains elusive. We characterized the epigenetic status of hybrid ecDNA using HPVOPC cell lines and patient-derived tumor xenografts, identifying HPV oncogenes E6/E7 in hybrid ecDNA were flanked by novel somatic DNA enhancers and HPV L1 enhancers, with strong cis-interaction. Targeting of these enhancers by clustered regularly interspaced short palindromic repeats interference or hybrid ecDNA by bromodomain and extra-terminal inhibitor reduced E6/E7 expression, and significantly inhibited in vitro and/or in vivo growth only in ecDNA(+) models. HPV DNA in hybrid ecDNA structures are associated with novel somatic and HPV enhancers in hybrid ecDNA that drive HPV ongogene expression and carcinogenesis, and can be targeted with ecDNA disrupting therapeutics.