Aim of the study:
To assess the stability of medication adherence and risk factors for non-adherence in outpatients with schizophrenia after hospital discharge.

Subject or material and methods:
Patients with schizophrenia (n=40) were recruited one month after hospital discharge for acute hospitalization and followed up for 5 months. Medication adherence and relevant clinical variables and socio-demographic factors were assessed at baseline and at the end of follow-up.

Results:
One month after hospital discharge 32.5% of the patients showed high treatment adherence. Adherence rates decreased further up to 16.7% six months after hospital discharge. While antipsychotic side effects differentiated adherent from non-adherent patients at baseline, both groups were differentiated at follow-up by the level of insight. Non-adherence prior to hospitalization and in the first month after hospital discharge, and hospitalization in the previous year predicted further non-adherence.

Discussion:
Medication adherence in schizophrenia decreases substantially after hospital discharge with partial adherence being common in clinical practice. Risk factors for non-adherence have been identified. The post-discharge period seems important for establishing high treatment adherence in schizophrenia.

Conclusions:
Vigorous interventions in community-based settings should be applied in the post-discharge period in order to improve medication adherence and outcome in outpatients with schizophrenia.