Electronic Prescription Systems and Medication Adherence in Schizophrenia: A Systematic Review of Digital Integration and Implementation Evidence
Abstract
Medication non-adherence among patients with schizophrenia ranges from 40% to 60% and is a major factor contributing to relapse and rehospitalization. Objective assessment of medication adherence was facilitated through an electronic prescription system (SRE), although evidence regarding its effectiveness and implementation remains limited. This study aimed to evaluate the effectiveness of SRE in improving medication adherence among patients with schizophrenia and to identify factors influencing its implementation. A literature search was conducted in PubMed, Scopus, PsycINFO, Embase, and Web of Science for studies published between 2015–2025. Study was assessed using the RoB-2, ROBINS-I, CASP, and GRADE instruments. Data were synthesized using a thematic approach and a random effects model. A total of 501 studies were identified, of which eligible studies were included in the final synthesis. The findings indicated that SRE (Schizophine Recognition Elements) improved the objective identification of medication non-adherence, with measured medication adherence (p=0.001) and may contribute to relapse prevention among patients with schizophrenia. The use of long-acting antipsychotics (LAIs) was also associated with better adherence, with adherence rates ranging from 46% to 61%. The main barriers to implementation included poor internet connectivity, resistant among healthcare professionals, non-user-friendly interfaces, and limited digital literacy. Overall, SRE appears to be an effective strategy for improving medication adherence among patients with schizophrenia , particularly when supported by healthcare interventions and the use of LAIs. Successful implementation requires institutional commitment, standardized performance metrics, and effective integration into routine clinical practice.
Keywords: Electronic prescribing, medication adherence, schizophrenia
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DOI: http://dx.doi.org/10.30829/contagion.v8i3.29864
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