The need for educating patients with schizophrenia about the adverse effects of medications

Effectiveness of Providing Information on Antipsychotic Medication to Patients with Psychotic Disorders: An Integrative Review

The aim of this integrative literature review is to describe the information provided to patients with psychotic disorders regarding their medication and to consider the effectiveness of providing such information. Searches of four databases identified 16 articles that met inclusion criteria. Results indicated that patients had relatively poor knowledge about their medications overall. Knowledge about side effects was found to improve significantly following education, with better knowledge leading to positive patient outcomes including increased adherence. Findings offer a comprehensive description of antipsychotic medication information provided to patients and an indication of the positive impact of information provision.

Pharmacist-led interventions for people living with severe and persistent mental illness: A systematic review

OBJECTIVE

People living with severe and persistent mental illness experience poorer physical health, often due to medication and preventable lifestyle factors, and exacerbated by barriers to accessing healthcare services. Pharmacists are well-positioned to improve the physical and mental health of this population. However, little is known about pharmacists' current practices when providing services to this population nor the impact of pharmacist-led interventions on consumer health outcomes. We undertook a systematic review to identify, describe and assess the effectiveness of pharmacist-led interventions for supporting people living with severe and persistent mental illness and the impact on consumer outcomes.

METHODS

MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Scopus, Cochrane Library, International Pharmaceutical Abstracts and ProQuest Dissertations and Theses were searched between January 1990 and April 2020. Full-text studies exploring pharmacist-led interventions in any setting for people living with severe and persistent mental illness were included. A risk of bias assessment was conducted.

RESULTS

A total of 37 studies were included. More than half of the pharmacist interventions were multifaceted. The most common components of pharmacist-led interventions included education and/or patient counselling, providing recommendations to healthcare professionals and conducting medication reviews. Multifaceted interventions demonstrated improvements in clinical outcomes, whereas single interventions focused mostly on consumer-reported outcomes. The methodological quality of included studies was moderate-to-high risk of bias and there was considerable heterogeneity in the study design, interventions described, and outcomes reported.

CONCLUSION

There is evidence that pharmacist-led interventions improve consumer-reported and clinical outcomes for people living with severe and persistent mental illness. Pharmacists are capable and have a role in supporting people living with severe and persistent mental illness, either individually or as interprofessional collaborators with other healthcare professionals. Future research should attempt to better understand which particular intervention components have the greatest impact and also evaluate the implementation and long-term sustainability of such interventions.

Perceptions of Family Caregivers of Patients with Schizophrenia Towards Antipsychotics Associated Side-Effects in China:A Qualitative Study

PURPOSE

To explore perceptions of antipsychotics associated side-effects among family caregivers of patients with schizophrenia.

PATIENTS AND METHODS

A descriptive qualitative study was applied in a tertiary referral hospital in China. Purposeful sampling of 18 family caregivers of patients with schizophrenia were interviewed about their perceptions towards antipsychotics related side effects.

RESULTS

According to content analysis, three themes emerged from the data: (a) nightmare in the treatment with the categories of sleep disturbances; physical impairment; appearance impairment; (b) opposite attitudes toward side-effect with the categories of being vigilant; do not care; (c) diverse ways of coping side-effects with the categories of asking for help from professionals; self-determined; try any quack's prescription.

CONCLUSION

The side effects of antipsychotics not only damage the health of patients, but also increase the burden and stress of caregivers. However, caregivers have different attitudes and coping styles about the side effects of antipsychotics. Health professionals should be aware of the influence of individual background and cultural factors on caregivers' attitudes towards drug side effects. Furthermore, health professionals should also provide caregivers with knowledge about drug side effects, coping skills, and appropriate management strategies to promote health outcomes for people with schizophrenia.

Process in medication self-management: The perspective of Chinese patients with schizophrenia

This study aimed to explore the medication self-management experience of Chinese patients with schizophrenia who are prescribed antipsychotics. Grounded theory methodology was used to guide the research. Semistructured and in-depth interviews with 17 patients with schizophrenia were conducted and analysed. The six categories identified in this study portray an evolving journey for participants, from initially obeying the orders of psychiatrists or family members to actively engaging in medication management. Six main categories emerged from the data: (i) obeying the orders; (ii) perceiving the changes; (iii) appraising the changes; (iv) making some adjustments; (v) generating insight into medication-taking; and (vi) transcending themselves. The findings from the study indicate that the participants' experience antipsychotic management is complex and that the medication self-management behaviour trajectory is a continuous, dynamic, and progressive process. Health care professionals should identify the characteristics of medication self-management behaviour changes in patients with schizophrenia according to their actual situation and provide correct, timely and adequate guidance for patients.