Effects of empowerment‐based illness management on the medication adherence and recovery of persons with schizophrenia: A systematic review and meta‐analysis

Hsieh, Wen-Ling; Li, I-Hsien; Liu, Wen-I

doi:10.1111/inm.13123

Cited by 11 publications

(3 citation statements)

References 50 publications

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“…Although many interventions in mental health care aim to reduce symptoms and improve functioning, there is room to focus more on a holistic approach to adequately address underlying risk or etiologic factors. Moreover, measures such as empowerment and hope have been strongly associated with personal recovery and should receive adequate attention in mental health care interventions (Hsieh et al, 2023; Leendertse et al, 2021). Supplementing ESM monitoring with personalized feedback seems to deepen insight into the contexts and mechanisms that affect fluctuations of momentary experiences, symptoms, and functioning and may provide an individual with the skills and confidence to recognize and manage their own mental health (Ben-Zeev et al, 2019), in line with the principles of psychiatric rehabilitation and recovery.…”

Section: Discussionmentioning

confidence: 99%

Monitoring momentary subjective well-being and psychotic experiences during antipsychotic dose reduction: Two single-case time series experience sampling method pilot study.

Oomen,

Simons,

Broekmans-Madikrama

et al. 2024

Psychiatric Rehabilitation Journal

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Objective: Personalized dose optimization is desirable to improve subjective well-being and support rehabilitation. Therefore, N = 1 trials investigating tools to self-manage functional outcomes during dose optimization are necessary. The aim of this pilot study was to determine in two N = 1 trials whether an experience sampling method (ESM) smartphone app could be used to monitor and detect changes in subjective well-being and psychotic experiences during and after dose reduction. Method: Two participants with a psychotic disorder in remission underwent gradual dose reduction under a longitudinal selfmonitoring paradigm, accompanied by regular clinical monitoring by the attending physician. Subjective well-being was monitored with an (ESM) app through momentary affective experience (positive and negative affect) and physical well-being (tiredness, feeling unwell, and pain). Momentary psychotic experiences were assessed with four items. Time-series linear regression models were used to detect changes in reduction phases compared to baseline. Results: Whereas significant improvements in subjective wellbeing and psychotic experiences during dose reduction were detected in one participant, the opposite was demonstrated for the other participant, showing worsened subjective well-being and increased psychotic experiences in the reduction phase compared to baseline. Conclusions and Implications for Practice: Selfmonitoring with an ESM smartphone app offers a tool for detecting changes in subjective well-being and psychotic experiences during antipsychotic dose reduction. In this way, ESM may increase an individual's sense of control and empowerment. It may further facilitate dose optimization and shared decision-making at an individual level, which is required considering the high heterogeneity in psychotic disorders. Impact and ImplicationsThe present study shows that subtle changes in momentary subjective well-being and psychotic experiences during dose reduction can be identified with the experience sampling method. Whereas one participant reported an increase in subjective well-being and fewer psychotic experiences, the other participant reported a decrease in subjective well-being and increased psychotic experiences. These results further indicate substantial heterogeneity and underscore the importance of exploring and monitoring dose optimization at an individual level. Experience sampling method smartphone technology may be a suitable tool to facilitate early signaling of meaningful psychological changes and self-management of outcomes during antipsychotic dose optimization. Furthermore, it may promote rehabilitation by increasing an individual's sense of control and empowerment, and it may guide shared decision-making during the process of dose reduction.

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Section: Discussionmentioning

confidence: 99%

Monitoring momentary subjective well-being and psychotic experiences during antipsychotic dose reduction: Two single-case time series experience sampling method pilot study.

Oomen,

Simons,

Broekmans-Madikrama

et al. 2024

Psychiatric Rehabilitation Journal

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“…When primary care practitioners focus on the quality of their relationships with individuals with SMI and weight gain, care planning and follow-through for individuals is greatly enhanced, 144 and ongoing participation of individuals and families in goal-setting and decision-making is associated with sustained, positive behaviour changes. 146…”

Section: Discussionmentioning

confidence: 99%

REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) in people living with severe mental illness

MacPhee,

Howe,

Habib

et al. 2024

Preprint

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Introduction Antipsychotic medications are used to treat individuals with severe mental illness. These medications are associated with rapid weight gain and several physical and mental risk factors. Early, proactive weight management is necessary to pre-empt these risk factors. Methods A realist review was conducted to identify contextual factors and underlying mechanisms associated with effective, non-pharmacological weight management interventions for this population. A stakeholder group of practitioners and a stakeholder group of individuals with lived experience and their family carers were integral to the review process. Results The realist review consisted of 58 documents where 41 papers were intervention studies of non-pharmacological weight management interventions for individuals with severe mental illness. Weight management interventions typically included nutrition counseling, physical activity and behaviour therapies offered over different time ranges by combinations of facilitators. Follow-up was rarely reported, and these intervention studies yielded mixed outcomes for weight loss/weight gain prevention, decreased clinical risk indicators and improved physical and mental health. Review documents and stakeholder discussions were used to construct a programme theory and 12 testable context-mechanism-outcome configurations. Review findings emphasise the significant effect of stigma/double stigma on individuals with severe mental illness and weight gain. Therapeutic practitioner relationships, family and peer support contribute to individuals' engagement with healthy behaviours. Conclusions Multi-country non-pharmacological interventions for weight management have had mixed results. This realist review identified characteristics and potential mechanisms that may make a significant, positive difference to individuals with severe mental illness. A realist evaluation with primary data is currently underway.

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“…Antipsychotic drugs are the mainstay of its treatment, however, about 26.5% to 58.8% of people with SZ are non-adherent to their antipsychotic medication regimen [10,11]. Some factors linked with nonadherence include not being well informed about medications and the negative perceptions of taking medications [6,[11][12][13][14]. Poor adherence, in turn, is associated with a higher risk of symptom recurrence, rehospitalization, poor quality of life, and healthcare costs [15,16].…”

Section: Introductionmentioning

confidence: 99%

Second Generation Long-Acting Injectable Antipsychotics in Schizophrenia: The Patient’s Subjective Quality of Life, Well-Being, and Satisfaction

Brasso,

Bellino,

Bozzatello

et al. 2023

JCM

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Schizophrenia (SZ) is among the twenty most disabling diseases worldwide. Subjective quality of life, well-being, and satisfaction are core elements to achieving personal recovery from the disorder. Long-acting injectable second-generation antipsychotics (SGA-LAIs) represent a valid therapeutic option for the treatment of SZ as they guarantee good efficacy and adherence to treatment. The aim of this rapid review is to summarize the evidence on the efficacy of SGA-LAIs in improving subjective quality of life, well-being, and satisfaction. The PubMed database was searched for original studies using SGA, LAI, risperidone, paliperidone, aripiprazole, olanzapine, SZ, and psychosis as keywords. Twenty-one studies were included: 13 clinical trials, 7 observational studies, and 1 post hoc analysis. It has been shown that SGA-LAIs bring an improvement to specific domains of subjective and self-rated quality of life, well-being, or satisfaction in prospective observational studies without a control arm and in randomized controlled trials versus placebo. The superiority of SGA-LAIs as compared with oral equivalents and haloperidol-LAI has been reported by some randomized controlled and observational studies. Although promising, the evidence is still limited because of the lack of studies and several methodological issues concerning the choice of the sample, the evaluation of the outcome variables, and the study design. New methodologically sound studies are needed.

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Effects of empowerment‐based illness management on the medication adherence and recovery of persons with schizophrenia: A systematic review and meta‐analysis

Cited by 11 publications

References 50 publications

Monitoring momentary subjective well-being and psychotic experiences during antipsychotic dose reduction: Two single-case time series experience sampling method pilot study.

Monitoring momentary subjective well-being and psychotic experiences during antipsychotic dose reduction: Two single-case time series experience sampling method pilot study.

REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) in people living with severe mental illness

Second Generation Long-Acting Injectable Antipsychotics in Schizophrenia: The Patient’s Subjective Quality of Life, Well-Being, and Satisfaction

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