Peers experience of delivering a problem-solving programme to enhance antipsychotic medication adherence for individuals with schizophrenia

Identifying key roles and responsibilities of peer workers in behavioral health services: A scoping review

OBJECTIVE

The roles and responsibilities of peer workers (PWs) are not well articulated. This scoping review aims to systematically identify and describe the roles of PWs in outpatient, community based mental health and substance use services, and compare their roles and responsibilities across these service settings METHODS: The scoping review was a priori developed and implemented according to the Joanna Briggs Institute methodology, which includes stating the review objectives, conducting a three-step search method, and charting the results.

RESULTS

Forty-four peer reviewed manuscripts were included in the review. PWs were used more often in mental health (n = 27) than substance use (n = 10) programs. Peers adopted a wide range of skills. Across program contexts, peers were frequently used as a source of informal support or mentorship and care coordination. Mental health programs often used peers to deliver manualized interventions, while substance use programs more frequently leveraged PWs to facilitate service linkage and engagement.

CONCLUSION

Roles of peers differed between substance use and mental health programs, reflecting significant diversity in how peers are being integrated into the behavioral health workforce.

PRACTICE IMPLICATIONS

Peer certification programs must balance consistency with the wide range of skills required of this workforce.

Management of Schizophrenia Spectrum Disorders in the Outpatient Setting: A Quality Improvement Project

Antipsychotic medications are the basis for treatment of schizophrenia spectrum disorders. Despite symptom improvement with antipsychotic medications for these patients, nonadherence to medications persists which may lead to symptom reoccurrence, decreased quality of life, and increased rates of rehospitalization. The aim of this quality improvement project was to determine, through a retrospective analysis, factors impacting treatment adherence in an outpatient setting in Central Florida for patients with a schizophrenia spectrum disorder enrolled in a patient assistance program to identify gaps in care/services in order to improve quality care. Data were collected using convenience sampling from an electronic health record at an outpatient clinic. Logistic regression was used to identify any possible correlations between personal and social factors related to treatment adherence. Lack of life skills coaching, insurance, utilization of decanoate medications, and side effects decreased the likelihood of stability at the last visit. Significant odds of instability at the last visit was 27% higher for clients with a substance abuse history. While medication nonadherence remains a challenge in patients diagnosed with schizophrenia spectrum disorders, several components of care appeared to positively influence treatment outcomes. Quality improvement recommendations based on identified gaps were made to improve medication nonadherence in practice.