Medication nonadherence and psychiatry

Abstract

Purpose of reviewNonadherence to appropriately prescribed medication for psychiatric disorders prevents patients from realizing the full benefits of their treatment and negatively impacts on individuals, their families and the healthcare system. Understanding and reducing nonadherence is therefore a key challenge to quality care for patients with psychiatric disorders. This review highlights findings regarding the prevalence and consequence of nonadherence, barriers to adherence and new intervention methods from 2012 onwards.Recent findingsRecent research has highlighted that nonadherence is a global challenge for psychiatry and has linked nonadherence to poorer outcomes, including hospital admissions, suicide and mortality. Optimizing medication regimens can reduce nonadherence; however, often a complex interplay of factors affects individuals’ motivation and ability to follow their prescription. Psychiatrists can enable patients to develop an accurate model of their illness and treatment and facilitate adherence. However, nonadherence is often a hidden issue within consultations. Novel interventions using new technologies and tailoring techniques may have the potential to reduce nonadherence.SummaryNonadherence remains a significant challenge for patients with psychiatric disorders, physicians and healthcare systems. New developments demonstrate the importance of developing tailored interventions to enable patients to overcome perceptual and practical barriers to adherence.

A review of self-report medication side effect questionnaires for mental health patients

“…Discontinuing treatment or non-adherence often leads to rehospitalization, relationship breakdown, loss of housing, loss of employment, involvement in substance abuse, crime and suicide (Ascher-Svanum et al, 2008;Yen et al, 2009;Chapman and Horne, 2013). This vicious cycle of illness, prescribed medication leading to intolerable side effects, non-adherence, discontinuation effects (which can mimic and be practically indistinguishable from illness relapse) (Cerovecki et al, 2013) and/or frank illness relapse is seen in a large number of mental health patients with serious consequences and who in the worse cases, take their own life (Naber and Karow, 2001;Llorca, 2008).…”

Indicadores de reinternação em enfermaria de psiquiatria

“…Além disso, a garantia de adesão ao tratamento esteve associada com redução dos índices de perda de anos de vida pela doença, que incapacita a força de trabalho; diminuição da morbidade, com melhor expectativa de vida para pacientes psiquiátricos graves; retração de gastos com internações hospitalares; retração de mortes por suicídio de pacientes com depressão, TAB e esquizofrenia; e centralização do tratamento em centros de atendimento psicossocial 12 . Este estudo é limitado pelo pequeno volume de dados que foi possível coletar de forma confiável pelo método retrospectivo.…”

Antipsychotic medication side effect assessment tools: A systematic review

“…Discontinuing antipsychotic medication often leads to relapse in psychotic disorders, which in turn may result in loss of employment, loss of housing, relationship and social problems and increased risk of suicide (Ascher-Svanum et al, 2008;Chapman and Horne, 2013;Yen et al, 2009). Evidently, mental health consumers may find themselves in a perpetual pattern of illness occurrence, prescribed medication subsequently producing unendurable side effects, discontinuation of medication and eventual relapse (Llorca, 2008;Naber and Karow, 2001;Salomon and Hamilton, 2013).…”