Research and development of the P-PORCH case management model to improve medication adherence in patients with severe and persistent schizophrenia
DOI:
https://doi.org/10.64838/jmht.2025.278603Keywords:
case management, medication adherence, mindfulness, schizophrenia, severe and persistent schizophreniaAbstract
Objective: To develop and evaluate the effect of a case management-based care model on medication adherence in severe and persistent schizophrenic patients.
Methods: This research and development study consisted of two phases. The first phase developed the care model, using expert group discussions, document reviews, and literature reviews. The second phase evaluated the effect of the model using a quasi-experimental, one-group pretest-posttest design. Participants were patients with severe and persistent schizophrenia who had experienced relapse due to medication non-adherence. Medication adherence scores were measured before and after intervention, and at 1- and 3- month follow-ups. Data were analyzed using repeated measures ANOVA.
Results: The P-PORCH model is a case management approach focusing on mindfulness, self-awareness (insight), and self-care skills. It consists of six steps: preparing a case manager, patient care planning, operation, regulatory monitoring, (multidisciplinary) coordination, and health care evaluation. The model includes 14 activities delivered over a 20-day period. Preliminary testing with 40 participants showed a statistically significant increase in medical adherence scores immediately after the intervention, which remained stable or showed a slight decline during the 3-month follow-up.
Conclusion: The P-PORCH model can be integrated into the care of patients with schizophrenia who experience medication non-adherence, and shows potential to improve treatment adherence in this challenging population.
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