No abstract

Treatment nonadherence is a formidable challenge in today's clinical practice. Despite decades of focused research, medication adherence continues to be a significant risk factor for poor prognosis in schizophrenia. Studies demonstrate that no single strategy is effective for all patients and that a multidisciplinary approach customized to the patient's individual needs results in improved adherence rates. This Open Forum presents a comprehensive model for organizing and incorporating current and future evidence-based strategies with a focus on educational strategies, psychotherapeutic techniques, and a strong therapeutic alliance.

Adherence in mood and psychotic disorders can be improved when providers take time to build trusting relationships; identify risk factors; anticipate nonadherence; individualize treatment; and educate patients, families, and other healthcare providers.

Purpose of ReviewThe aim of this review is to critically evaluate recent literature on the use of telepsychiatry in emergency departments (EDTP) and synthesize the evidence on telepsychiatry during public health emergencies. We also report on experiences and success stories from a state-wide EDTP program in South Carolina during the COVID-19 pandemic. Recent Findings We identified 12 peer-reviewed articles published between January 2019 and February 2021 that evaluated EDTP interventions and their impact on patient outcomes. The recent evidence on EDTP shows a significant association between EDTP implementation or use and decreased patients' wait time in emergency department (ED), shorter length of stay in certain settings, reduced ED revisit rates, improved ED patient disposition (e.g., more discharge to home, less observational stays, and decreased inpatient admissions), and reduced follow-up encounters involving self-harm diagnosis. Summary The EDTP virtual delivery model can help healthcare systems reduce burden of public health emergencies on providers, staff, and patients alike. While a disruption of magnitude seen by COVID-19 may be infrequent, strategies used during the pandemic may be implemented to enhance care in rural settings, and/or enhance preparedness of communities and healthcare systems during more commonly occurring natural disasters.