Adherence to Psychotropic Medications and Associated Factors in Primary Health Care

Miasso, Adriana Inocenti; Filho, Paulo Celso Prado Telles; Borges, Tatiana Longo; Júnior, Assis do Carmo Pereira; Vedana, Kelly Graziani Giacchero; Shasanmi, Rebecca O.; Gimenes, Fernanda Raphael Escobar

doi:10.1080/01612840.2016.1214854

Cited by 9 publications

(11 citation statements)

References 49 publications

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“…The most frequent interactions involved fluoxetine, haloperidol and carbamazepine, the last two also recurring in interactions detected at basic care facilities that treat mental disorders. 12 The frequent use of haloperidol in this and other studies underscores the important role of this drug in antipsychotic polytherapy, as well as concerns regarding its prescription patterns in the treatment of mental health. 13 Identifying the main potential interactions at the CAPS is important in guiding the multidisciplinary team, and monitoring the signs, symptoms and toxic effects of drug interactions on priority groups of users, until their inclusion in all the services.…”

Section: Discussionmentioning

confidence: 99%

“…Exacerbating a side effect that poses no serious health risk but affects the routine and behavior of the user, could be clinically significant and may negatively affect adherence to therapy, a frequent and relevant problem for these users. 12 The clinical management to be carried out for more frequent interactions are related to the monitoring of serum levels of the drugs and mainly to the occurrence of typical symptoms of intoxication by one of the medicines. The Serotonin syndrome is a potentially lethal condition that can be caused by interactions with medications in the treatment of mental disorders and requires the attention of health professional.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

Silva¹,

Lima²,

Ruas³

2018

JYP

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Background: In the mental health field, the psychotropic polypharmacy is frequently observed, a significant risk factor for the occurrence of drug interactions. Objective: Identify potential drug interactions on the prescriptions of mental health services users and describe the associated factors. Methods: A cross-sectional study was conducted in 11 services. Sociodemographic data and information about the use of drug were obtained through interviews of users, analysis of prescriptions and medical charts, using a semi-structured questionnaire. Potential drug interactions were identified using the Micromedex® database, the association with sociodemographic characteristics and aspects related to the medicines prescribed were analyzed using the prevalence ratio. Results: The number of medicines prescribed ranged from 0 to 9, with an average of 3.38 (SD=1.76) per user, the most prescribed being haloperidol (12.3%), clonazepam (8.2%) and biperiden (7.9%). The proportion of interactions considering the number of users interviewed was 35.1%. The most frequent between potential interactions were haloperidol and fluoxetine (9.1%); haloperidol and carbamazepine (8.8%); and carbamazepine and chlorpromazine (5.9%). The highest prevalence ratio (PR) for the occurrence of potential interactions was in women (PR=1.36; 95% CI 1.08:1.71), users who had reported improper medicine use (PR=1.36; 95% CI: 1.07:1.72) and those with more than 5 prescribed medicines (PR=1.87; 95% CI: 1.49:2.33). Conclusion: Potential drug interactions were observed in more than one-third of the user's Brazilian mental health services. The profile of interactions detected could guide the pharmacotherapeutic follow-up of priority users, and help the multidisciplinary team identify signs and symptoms that can influence the treatment of users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

Silva¹,

Lima²,

Ruas³

2018

JYP

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“…A significant number of patients experience anxiety (treated with antidepressants– serotonergic agents), agitation, seizures, ADHD, irritability, and aggressive behaviors. The use of CNS and psychoactive agents can place patients at significant risk for adherence problems, adverse effects, and related medication safety concerns . Both ADHD medications and antidepressants contributed high percentages to the total mean MRCI score, 15.1% and 14.5%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Patient‐Level Medication Regimen Complexity in an Adolescent and Adult Population with Autism Spectrum Disorders

Barnette

Hanks

et al. 2019

Pharmacotherapy

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BACKGROUND Adults with autism spectrum disorder (ASD) frequently experience polypharmacy. However, there is limited understanding of how to quantify medication complexity in this vulnerable population. OBJECTIVES This study examined medication administration difficulty using the Medication Regimen Complexity Index (MRCI) tool in adolescents and adults with ASD. The outcomes compared the mean total MRCI score with the medication count, described MRCI contributions for over-the-counter medication (OTC), and compared MRCI scores by patient characteristics. METHODS This was a retrospective chart review of patients aged 7-45 years (mean = 20.1) enrolled in a primary care ASD transitions program. Each patient's listed medications were counted and then scored using the validated MRCI tool. RESULTS For the 142 patients studied, mean total MRCI was 14.6 AE 14.6 (range 0-89) and mean medication count was 6.3 AE 5.4 (range 0-38). For patients on 0-4 medications (66 of 142; 46.5%), the mean MRCI was 5.5 AE 4.2, 5-9 medications (50 of 142; 35.2%) the mean MRCI was 15.2 AE 6.8, and 10-38 medications (26 of 142; 18.3%) the mean MRCI was 36.5 AE 18.9 (p<0.001). Sixty percent (85 of 142) reported OTC use, which contributed 26.6% to the mean total MRCI. Reported benzodiazepine (mean MRCI 25.8 AE 17.2), antiepileptic (mean MRCI 23.7 AE 16.9), antipsychotic (mean MRCI 19.7 AE 15.9), or antidepressant (mean MRCI 17.0 AE 14.8) use received higher MRCI scores compared to nonuse (p<0.001 for all except antidepressants [p=0.004]). Total MRCI did not differ significantly by age group, sex, or attention-deficit-hyperactivity disorder (ADHD) medication use (stimulant or nonstimulant). CONCLUSIONS Medication regimen complexity in adolescents and adults with ASD was increased significantly for individuals taking ≥ 5 medications. Central nervous system agent use, other than ADHD therapy, identified patients with higher regimen complexity. The related clinical effects of these findings warrant further investigation.

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“…A não adesão pode estar relacionada ao que é chamado de situações não intencionais, favorecidas pelas limitações do portador de transtorno mental em fazer o uso da medicação, seja por esquecimento, esquema terapêutico complexo (como horários, dosagens, medicamentos com cores e formas parecidas) ou questões cognitivas ocasionadas ou não pelo transtorno (22) .…”

Section: Discussionunclassified

Uso De Psicofármacos Pelo Portador De Transtorno Mental: Percepções Do Enfermeiro

Czarnobay

Brusamarello²,

Capistrano³

et al. 2018

Cogitare Enferm.

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RESUMO: Objetivo: apreender as percepções do enfermeiro sobre a adesão pelo portador de transtorno mental ao uso de psicofármacos. Método: pesquisa qualitativa exploratória, desenvolvida em 2015 por entrevistas semiestruturadas com 23 enfermeiros atuantes em quatro Centros de Atenção Psicossocial, localizados no estado do Paraná. Os resultados foram analisados com a técnica Análise Temática Categorial proposta por Bardin. Resultados: os participantes trouxeram percepções referentes aos aspectos que contribuem para a adesão dos portadores de transtorno mental ao uso de psicofármaco, como o atendimento por equipe multiprofissional, vínculo terapêutico com a equipe, fé e espiritualidade, família, entre outros. Relataram os fatores que contribuem para a não adesão, como os efeitos colaterais e adversos, fanatismo religioso, ausência familiar, entre outros. Conclusão: o conhecimento pelo enfermeiro das efetivas ações educativas em saúde aos portadores de transtorno mental e seus familiares deve considerar as necessidades, limitações e potencialidades de cada um. DESCRITORES: Adesão à medicação; Enfermagem; Saúde mental; Transtorno Mental. USO DE PSICOFÁRMACOS PELO PORTADOR DE TRANSTORNO MENTAL:PERCEPÇÕES DO ENFERMEIRO* USE OF PSYCHOACTIVE DRUGS BY PEOPLE WITH MENTAL DISORDERS: PERCEPTIONS OF NURSESABSTRACT: Objective: To know the perceptions of nurses on adherence to the use of psychoactive drugs by people with mental disorders. Methods: Exploratory qualitative study developed in 2015, through the application of semi-structured interviews with 23 nurses who worked in four psychosocial care centers in the state of Paraná. The results were analyzed using the categorical thematic analysis technique, proposed by Bardin. Results: The participants reported perceptions referring to the aspects that contribute to adherence of people with mental disorders to the use of psychopharmaceuticals, such as support from a multiprofessional team, therapeutic bond to the healthcare team, faith and spirituality, and family. The interviewees also listed the factors that hinder adherence, such as side and adverse effects, religious fanaticism and absent family. Conclusion: The knowledge of nurses on effective educational health actions oriented to people with mental disorder and their relatives should take into consideration the needs, limitations and potentialities of each individual.

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Adherence to Psychotropic Medications and Associated Factors in Primary Health Care

Cited by 9 publications

References 49 publications

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

Patient‐Level Medication Regimen Complexity in an Adolescent and Adult Population with Autism Spectrum Disorders

Uso De Psicofármacos Pelo Portador De Transtorno Mental: Percepções Do Enfermeiro

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