Promoting Medication Adherence Among Psychiatric Patients With a History of Nonadherence: A Clinical Practice Improvement Program.

Journal of Psychiatric Practice
Xiangbing Shepherd XiaNigila Ravichandran

Abstract

People with serious mental illness may require long-term psychotropic medications. However, nonadherence is prevalent after discharge, often leading to re-admission. Several strategies exist to reduce nonadherence. The current project uses clinical practice improvement methodologies to test and adjust strategies to improve medication adherence at the Institute of Mental Health in Singapore. Two focus groups (one of which involved nonadherent individuals and the other adherent individuals) were conducted to explore the root cause of our service users' nonadherence. On the basis of the causes identified, the team developed and implemented a person-centered medication adherence counseling intervention, incorporating motivational interviewing and psychoeducation. Data from all service users (n=156) who were nonadherent to psychotropic medications upon admission to our men's ward between October 2017 and December 2018 were examined, with 63 of the men serving as the baseline sample and 93 receiving the adherence intervention. The team also reduced medication frequency and actively explored patients' willingness to switch to long-acting injectable antipsychotics. A validated visual analogue self-reporting scale was used to measure ad...Continue Reading

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