Adherence According to Mary Poppins: Strategies to Make the Medicine Go Down

Abstract

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.

The relationship between medication-related problems and behavioural health condition among patients served by a health care for the homeless centre

“…The treatment of chronic behavioural health conditions requires complex therapy, the cornerstone of which is psychiatric medication [1,2] . When used appropriately, psychiatric medications help to relieve disease symptoms, prevent hospitalization and improve quality of life; however, improper use of these medications can result in medication‐related problems (MRPs), such as suboptimal treatment outcomes and an increased cost burden to the healthcare system [1–5] . In fact, several studies have linked psychiatric medication non‐adherence to poor disease management [6] and cyclical relapses, [2,3,6] with an economic burden of over US$800 million in hospital costs annually [6]…”

“…Patients taking psychiatric medications are more likely to experience any type of MRP than patients with stable housing [9] . Adverse effects caused by psychiatric medications, such as sedation and extrapyramidal side effects, and ineffective drug therapy, increase the risk for hospital readmission, and/or delayed recovery [2] …”

“…[1,2] When used appropriately, psychiatric medications help to relieve disease symptoms, prevent hospitalization and improve quality of life; however, improper use of these medications can result in medication-related problems (MRPs), such as suboptimal treatment outcomes and an increased cost burden to the healthcare system. [1][2][3][4][5] In fact, several studies have linked psychiatric medication nonadherence to poor disease management [6] and cyclical relapses, [2,3,6] with an economic burden of over US$800 million in hospital costs annually. [6] In addition to non-adherence, behavioural health patients may also experience other MRPs, which include adverse events, ineffective drug therapy, need for additional drug therapy, unnecessary drug therapy and drug interactions.…”

“…[9] Adverse effects caused by psychiatric medications, such as sedation and extrapyramidal side effects, and ineffective drug therapy, increase the risk for hospital readmission, and/or delayed recovery. [2] In addition to the challenges associated with medication therapy, 50% of patients with a psychiatric or mood disorder also suffer from comorbid substance abuse and are thus deemed to have a dual diagnosis. [2,10,11] Individuals suffering from a dual diagnosis face higher rates of relapse, delayed recovery, more frequent hospitalizations, poorer physical health and greater treatment costs.…”

“…[2] In addition to the challenges associated with medication therapy, 50% of patients with a psychiatric or mood disorder also suffer from comorbid substance abuse and are thus deemed to have a dual diagnosis. [2,10,11] Individuals suffering from a dual diagnosis face higher rates of relapse, delayed recovery, more frequent hospitalizations, poorer physical health and greater treatment costs. [10,12,13] Substance abuse also puts psychiatric patients at risk for drug-alcohol interactions.…”