Why and how people decide to stop taking prescribed psychiatric medication: Exploring the subjective process of choice.

Abstract

Implications of these findings are discussed, emphasizing the importance of the "doctor-patient" relationship context.

What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis

“…Sideeffects of anti-psychotic medication can also lead to changes in both self-identity and selfesteem, often through weight gain and sexual dysfunction (Johnstone et al, 2009;Laithwaite et al, 2007;Roe et al, 2009). …”

Improving medication adherence for severely mentally ill adults by decreasing coercion and increasing cooperation

“…Generally, research supports the view that medications decrease the severity of psychiatric symptoms (Roe et al, 2009). While medication does not cure symptoms, it does stabilize them (Allison, 2012).…”

“…Patients often mistake illness symptoms for side effects or they are overly preoccupied with side effects and thereby exacerbate them (Andreasson & Skarsater, 2012;Meehan, Sted-man, & Wallace, 2011). Roe et al (2009) reported that nonadherence can also result from disagreement between patient and provider. These points, and patient concerns about side effects, suggest the need for improved patient-provider communication about medications.…”

“…Patients have also been found to be less adherent to medications that interfere with personal goals such as working, exercising, and keeping busy (Roe et al, 2009). These concerns offer some support for the position advanced by Morrison et al (2000): Patients' decisions to not take medications, in spite of potential benefits, are at least somewhat rational and even a counterargument to the aforementioned position that severely mentally ill individuals who refuse medications are displaying a lack of insight.…”

“…According to multiple research studies, rates of adherence for adults with schizophrenia and other mental illnesses range from 30% to 50% (Allison, 2012;Deegan, 2007;Garcia, Chang, Young, Lopez, & Jenkins, 2006;Roe et al, 2009;Townsend, 2009). Research suggests that nonadherence exacerbates symptoms and correlates with increases in substance use and abuse, violence and other high-risk behaviors, and increased rates of completed suicide (Jarrett et al, 2008;Roe et al, 2009;Townsend, 2009). The pros and cons of medications combine to create profound ethical dilemmas for hospital providers, who must honor patient self-determination that may ultimately and even irreversibly be compromised if patient refusal of medications is respected (Munetz & Frese, 2001;Townsend, 2009).…”