Satisfaction with antipsychotics as a medication: the role of therapeutic alliance and patient-perceived participation in decision making in patients with schizophrenia spectrum disorder

Objectives The aim of this study was to identify independent predictors of satisfaction with antipsychotics in patients with schizophrenia spectrum disorders treated in a mental health catchment area.Methods Observational analytical study of patients (n = 150) recruited through a convenience sampling method from five mental health units. Satisfaction with the antipsychotic as a medication was evaluated using the Treatment Satisfaction Questionnaire for Medication (TSQM). Therapeutic alliance was assessed by the Working Alliance Inventory Short Form (WAI-S). Patient-perceived participation in decision-making was assessed using COMRADE (Combined Outcome Measure for Risk communication And treatment Decision making Effectiveness). A multiple linear regression analysis was performed to identify variables independently associated with the TSQM ‘Global Satisfaction’ total score.Results Two variables – age and higher level of self-perceived participation in treatment decision-making – were directly, significantly, and independently associated (β coefficient values: 0.209 and 0.432, respectively) with a higher TSQM Global satisfaction score. In addition, the severity of psychotic symptoms was inversely associated with satisfaction (β coefficient value: −0.205) (R2 = 0.355; R2 adj. = 0.291; F(13) = 5.554; p < 0.01).Conclusions These findings suggest that involving the patient in treatment decision-making and optimising the treatment to reduce symptoms, especially in younger patients, could increase satisfaction with antipsychotic treatment.Key PointsPatient involvement in shared decision-making is relevant for treatment satisfaction.Current evidence suggests that improving the doctor–patient relationship optimises antipsychotics outcomes.Self-perceived participation in decision-making predicts satisfaction with antipsychotic medication.Types of antipsychotics do not determine consistent differences in satisfaction.