Effectiveness of Two Methods for Informing Schizophrenic Patients About Neuroleptic Medication

Enhancing Informed Consent for Research and Treatment

“…Nevertheless, certain strategies may help subjects remember the material beyond the initial testing period (Kleinman et al 1996;Taub et al 1981;Tindall et al 1994;Wirshing et al 1998). Interventions that showed a benefit when delayed recall (generally several weeks later) was tested included an additional interaction (telephone call or information visit) with a nurse, (Dodd and Mood 1981;Aaronson et al 1996) informational videotape, (Weston et al 1997) written (vs. or in addition to oral) preoperative information, (Armstrong et al 1997;Askew et al 1990;Morrow et al 1978) simplified and illustrated presentations, (Krynski et al 1994;Tymchuk et al 1988;Tymchuk and Ouslander 1991), and corrected feedback or multiple learning trials (Kleinman et al 1993;Kleinman et al 1996;Taub et al 1981;Wadey and Frank 1997;White et al 1995;Wirshing et al 1998). …”

“…Two other positive reports examined the effects of providing illustrated, highly readable, large-print versions of clinical vignettes (Tymchuk and Ouslander 1991;Krynski et al 1994;Tymchuk et al 1988). Other positive interventions provided take-home information sheets 1 to 3 days before a scheduled procedure (Askew et al 1990;Morrow et al 1978), had a nurse review the consent information with the patient (Dodd and Mood 1981), gave corrected feedback to patients (Kleinman et al 1993), and had patients orally repeat the consent information (Wadey and Frank 1997;White et al 1995). A videotape intervention (which included "advance organizers" that alerted patients to the material to be presented, on-screen graphics, and summaries of key points) helped patients score better on a knowledge test (Agre et al 1994).…”

“…Patients with schizophrenia, as well as other populations, show a great deal of variance in performance. More important, patients in the studies reviewed have demonstrated substantial and clinically significant improvements in their performance on informed consent assessments when educational interventions were utilized (Rikkert et al 1997;Carpenter et al 2000;Kleinman et al 1993;Wirshing et al 1998). These observations suggest that clinicians may employ specific methods to identify those patients who may be at risk for inadequate understanding.…”

“…These strategies included an additional telephone discussion or informational visit from a nurse (Aaronson et al 1996;Dodd and Mood 1981), an informational videotape (Weston et al 1997), written (versus or in addition to oral) preoperative information (Armstrong et al All results statistically significant unless otherwise stated. 1997; Askew et al 1990;Morrow et al 1978), simplified and illustrated presentations (Krynski et al 1994;Tymchuk et al 1988;Tymchuk and Ouslander 1991), and corrected feedback and multiple learning trials ( Kleinman et al 1993;Kleinman et al 1996;Taub et al 1981;Wadey and Frank 1997;White et al 1995;Wirshing et al 1998).…”

“…In fact, studies comparing the abilities of patients with and without psychiatric illness have shown that the presence of a psychiatric disorder, albeit a risk factor, does not predetermine whether a patient can understand key information Appelbaum et al 1999;Grisso and Appelbaum 1995;Appelbaum and Grisso 1995;Lidz et al 1984;Meisel and Roth 1981;Roth et al 1987;Stanley et al 1987;Sugarman et al 1999;Carpenter et al 2000). Several investigators have demonstrated that individuals with psychiatric disorders do possess definite strengths related to decision-making capacity (Grisso and Appelbaum 1998;Carpenter et al 2000;Kleinman et al 1993;Stanley et al 1981;Soskis 1978).…”