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Cannabis use and adherence to antipsychotic medication: a systematic review and meta-analysis

Published online by Cambridge University Press:  09 February 2017

E. Foglia ,
T. Schoeler ,
E. Klamerus ,
K. Morgan  and
S. Bhattacharyya
E. Foglia
Affiliation:
King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
T. Schoeler
Affiliation:
King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
E. Klamerus
Affiliation:
King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
K. Morgan
Affiliation:
University of Westminster, London, UK
S. Bhattacharyya*
Affiliation:
King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
*
*Address for correspondence: S. Bhattacharyya, Ph.D., Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: sagnik.2.bhattacharyya@kcl.ac.uk)
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Abstract

Background

Substance use may increase the risk of non-adherence to antipsychotics, resulting in negative outcomes in patients with psychosis.

Method

We aimed to quantitatively summarize evidence regarding the effect of cannabis use, the most commonly used illicit drug amongst those with psychosis, on adherence to antipsychotic medication. Studies were identified through a systematic database search. Adopting random-effects models, pooled odds ratios (OR) for risk of non-adherence to antipsychotic medications were calculated comparing: cannabis-users at baseline v. non-users at baseline; non users v. continued cannabis users at follow-up; non-users v. former users at follow-up; former users v. current users.

Results

Fifteen observational studies (n = 3678) were included. Increased risk of non-adherence was observed for cannabis users compared to non-users (OR 2.46, n = 3055). At follow-up, increased risk of non-adherence was observed for current users compared to non-users (OR 5.79, n = 175) and former users (OR 5.5, n = 192), while there was no difference between former users and non-users (OR 1.12, n = 187).

Conclusions

Cannabis use increases the risk of non-adherence and quitting cannabis use may help adherence to antipsychotics. Thus, cannabis use may represent a potential target for intervention to improve medication adherence in those with psychosis.

Keywords

Antipsychoticcannabis usemedication adherencepsychosis
Type
Review Article
Information
Psychological Medicine , Volume 47 , Issue 10 , July 2017 , pp. 1691 - 1705
Copyright
Copyright © Cambridge University Press 2017 

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