Effects of empowerment‐based illness management on the medication adherence and recovery of persons with schizophrenia: A systematic review and meta‐analysis

• Published in: International journal of mental health nursing Vol. 32; no. 4; pp. 1008 - 1024
• Main Authors: Hsieh, Wen‐Ling, Li, I‐Hsien, Liu, Wen‐I
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.08.2023
• Subjects: Adherence; Antipsychotics; Behavior change; Clinical trials; Drugs; Empowerment; Humans; Illnesses; Medication Adherence; Meta-analysis; Motivation; Nurses; Patient compliance; Randomized Controlled Trials as Topic; Recovery; Recovery (Medical); Schizophrenia; Schizophrenia - drug therapy; Self-medication; Stigma; Systematic review; empowerment; meta-analysis; medication adherence; recovery; schizophrenia; systematic review
• ISSN: 1445-8330; 1447-0349
• DOI: 10.1111/inm.13123

Medication adherence and recovery rates are <50% among persons with schizophrenia; therefore, this health concern needs attention. Empowerment is a vital element for behavioural change, but previous studies have presented different results and lack specific connotations about empowerment. Therefore, this study systematically reviewed and meta‐analysed the effects of empowerment‐based illness management on the medication adherence and recovery of persons with schizophrenia. The databases searched included the PROSPERO registration network, Cochrane Library, PubMed, Embase, CINAHL, PsycAricle, and Airiti Library. The research steps were based on PRISMA. RoB 2.0 was used for article quality evaluation, the effect size was calculated using RevMan software, and the random‐effect model and standardized mean differences (SMD) were established. Eight randomized controlled trials (RCTs) involving 859 participants were used to investigate the effect of empowerment on medication adherence. The trials involved the use of effective strategies as inducing medication motivation, promoting self‐medication management, and providing support resources. A moderate effect was observed (SMD = 0.58, 95% CI 0.18–0.99). Ten RCTs involving 1473 participants were used to investigate the effect of empowerment on recovery. These trials involved the use of such effective strategies as using self‐strength, connecting external forces, understanding personal needs, and overcoming self‐stigma. A moderate effect was observed (SMD = 0.55, 95% CI 0.10–0.99). Empowerment in illness management can effectively promote the medication adherence and recovery of persons with schizophrenia. In the future, nurses can use self‐strength care to promote medication motivation and connect internal and external forces to assist a person's medication adherence and recovery.