Adherence to Medication Regimens and Participation in Dual-Focus Self-Help Groups

Abstract

Objective-The authors examined the associations between attendance at self-help meetings, adherence to psychiatric medication regimens, and mental health outcomes among members of a 12-step self-help organization specifically designed for persons with both chronic mental illness and a substance use disorder.Methods-A sample of members of Double Trouble in Recovery (DTR) was interviewed at baseline and one year later. Correlates of adherence to psychiatric medication regimens at the followup interview were identified for 240 attendees who had received a prescription for a psychiatric medication.Results-Consistent attendance at DTR meetings was associated with better adherence to medication regimens after baseline variables that were independently associated with adherence were controlled for. Three baseline variables were associated with adherence: living in supported housing, having fewer stressful life events, and having a lower severity of psychiatric symptoms. In addition, better adherence was associated with a lower severity of symptoms at one year and no psychiatric hospitalization during the follow-up period.Conclusions-Treatment programs and clinicians should encourage patients who have both mental illness and a substance use disorder to participate in dual-focus self-help groups that encourage the responsible use of effective psychiatric medication, particularly after discharge to community living. Clinicians also should be sensitive to stressful life events and discuss with patients how such events might affect their motivation or ability to continue taking medication.Poor adherence to psychiatric medication regimens is a major obstacle to the effective care of persons who have chronic mental illness. A recent review reported that patients who were receiving antipsychotics or antidepressants took an average of 58 percent and 65 percent,

Level of compliance and factors associated with non-compliance to treatment among the mentally ill patients

“…It is also seen that having someone to give medication on time or monitoring medications may have influence in compliance behavior and more likely to be adherent than those who lived without such support. 6 In this study quality of interaction with health professional is significantly associated with the level of compliance (P<0.05). A positive relationship with the therapist influenced much to patient's medication compliance.…”

“…Majority (78.0%) of the respondents had no family history of mental illness & 94.7% respondents visited the hospital for regular follow up visit. (Table 2: Clinical Characteristics of subjects) 6 Although antipsychotic medications have been shown to improve psychopathology, reduce relapse, & improve functioning non-adherence to treatment with antipsychotic is common. Improving adherence to treatment with antipsychotic medication in patients with psychotic disorders is a challenging task.…”

“…Nonadherence rates among mentally ill seen ranging from 20% to 80% with an average rate of approximately 50%. 5,6 Poor adherence to psychiatric medication regimens is a major obstacle to the effective care of persons who have chronic mental illnesses. A recent review reported that patient who was receiving antipsychotic or antidepressants took an average of 58% & 65% respectively of the prescribed dosage.…”

Mutual Help Groups for Mental Health Problems: A Review of Effectiveness Studies

“…Differences in attendance and level of participation may account for differences in outcome, a phenomenon analogous to the "dose-response" relationship in pharmacology. Several studies in the current review reported a correlation between higher levels Mutual help groups, p.19 of participation or involvement (operationalized in various ways) and positive outcomes (Caserta & Lund, 1993;Houston et al, 2002;Lieberman & Videka-Sherman, 1985;Magura et al, 2002).…”

Determinants of functioning and well-being among individuals with schizophrenia: An integrated model

“…Individuals who participated in more dual diagnosis services and 12-Step self-help groups showed slightly more gains in their use of problem-centered coping skills. A cross-sectional study also supported that the degree of participation in dualfocus (mental illness and addiction) self-help groups was significantly associated with degree of medication adherence (Magura, Laudet, Mahmood, Rosenblum, & Knight, 2002). Another prospective study (Lecomte et al, 1999) found that persons with severe mental illness participating in a 12-week treatment program geared toward improving self-esteem improved in active coping skills, in contrast with participants receiving treatment as usual.…”