BACKGROUND: Despite the fact that medication adherence is among the most important health related behaviors in relapse prevention and recovery in @entity161 , it is often not sufficiently endorsed by @entity1 . Poor insight and negative attitudes towards medication are risk factors for non-adherence. Their relationship and the influence of more general attitudes towards pharmacotherapy besides attitudes towards antipsychotics have not been fully understood. The present study investigated whether these factors independently influence adherence or whether they mediate one another. METHODS: A cross-sectional sample of 150 outpatients completed the Beliefs about Medication Questionnaire. It assesses @entity1 ' beliefs about antipsychotic medication in terms of necessity and concerns and more general beliefs about pharmacotherapy in terms of distrust. Additionally, the @entity1 ' global awareness of illness (Scale to assess Unawareness of @entity146 ), and medication adherence (Brief Adherence Rating Scale, Service Engagement Scale) were assessed. RESULTS: Using structural equation modeling, the study found evidence for a mediational model. Awareness of illness contributed to medication adherence via @entity1 ' perceived necessity of antipsychotics. The model further revealed a direct negative relationship between concerns regarding antipsychotics and adherence and an indirect negative effect of a general distrust regarding pharmacotherapy and adherence via antipsychotic specific attitudes. CONCLUSION: Interventions to enhance medication adherence may be more effective if they focus on treatment related attitudes rather than on global insight into illness. Clinicians may not only enhance the @entity1 ' perceived necessity of antipsychotic treatment but also explore and address concerns and the @entity1 ' distrust in pharmacotherapy in a more personalized way.

Are we addressing the 'right stuff' to enhance adherence in XXXX ? Understanding the role of insight and attitudes towards medication.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity161 :: ('MESH:D012559', 'Disease') :: ['schizophrenia'] @entity146 :: ('MESH:D001523', 'Disease') :: ['Mental Disorder']
@entity161 :: (MESH:D012559,Disease) :: ['schizophrenia']
