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Alvear Velásquez MJ, Sandoval Carrión IP. Adherence to psychopharmacological treatment in patients with severe and persistent mental disorders: A systematic review. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2024:S2530-3120(24)00025-0. [PMID: 39127548 DOI: 10.1016/j.rcpeng.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 11/09/2021] [Accepted: 01/03/2022] [Indexed: 08/12/2024]
Abstract
INTRODUCTION It is known that non-adherence to psychiatric medications has harmful consequences for both patients and society. OBJECTIVE To collect information on the incidence of non-adherence, and the factors and causes affecting adherence to psychopharmacological treatment in patients with severe and persistent mental disorders. METHODS A systematic review of scientific articles on adult patients (>17 years) published in the last five years (2015-2020) on specialised databases such as PubMed, Scopus, Scielo and BioMed. Original articles from indexed journals with an impact factor >0.5, in English or Spanish, with an analytical, prospective, retrospective, cross-sectional and randomised design were included. Once the articles were identified, they were analysed, extracting the information necessary to answer the research questions. RESULTS Fifteen articles were included. Of these, 40% (n = 6) were published in 2020, 20% (n = 3) were produced in China and 53.3% (n = 8) had an observational design. A total of 5,837 patients were included, of which 50.6% were men (n = 2,955), with moderate adherence (n = 10; 66.7%) reported in 10 investigations. Non-adherence varies from 7.7% to 60.6%. The factors that affect adherence are specific to the patient (age and sex), their family support network, and related to the disease or the treatment. The main cause of non-adherence is lack of insight. CONCLUSIONS Adherence to treatment with psychotropic drugs is multifactorial. Access to mental health services should be improved, with an emphasis placed on patient education and providing greater knowledge of mental illness. Interventions to promote education and interaction with the psychiatrist could be beneficial.
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Şahin Altun Ö, Asi Karakas S, Öztürk Z, Polat H. An analysis of the relationship between social support levels and treatment compliance of individuals diagnosed with schizophrenia. Perspect Psychiatr Care 2022; 58:578-583. [PMID: 33904170 DOI: 10.1111/ppc.12813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 03/05/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to determine the relationship between social support levels and treatment compliance of individuals with schizophrenia. DESIGN AND METHODS A descriptive and correlational research design was used in the study. The sample was not selected from the universe and the study was completed with 110 patients. FINDINGS There was a significant positive correlation between the total score of family subscale and total score of the Morisky compliance scale (p < 0.05). Morisky adherence scale (p < 0.05), suggesting that family support can favor the treatment adherence of patients. PRACTICE IMPLICATIONS Psychiatric professionals should carefully evaluate the family support perceived from the patients with schizophrenia to improve their adherence to treatment.
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Affiliation(s)
- Özlem Şahin Altun
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Sibel Asi Karakas
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Zeynep Öztürk
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Hatice Polat
- Malatya Education and Research Hospital Psychiatry Clinic, Malatya, Turkey
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Nyanyiwa S, Peters K, Murphy G. A scoping review: Treatment attitudes and adherence for adults with schizophrenia. J Clin Nurs 2022; 31:3060-3075. [PMID: 35043496 DOI: 10.1111/jocn.16219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/22/2021] [Accepted: 01/04/2022] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES This scoping review presents an exploration of literature on the relationship between treatment attitudes and adherence in adults experiencing schizophrenia. BACKGROUND Strategies to address adherence and improve treatment outcomes are described in literature. However, adherence remains a challenge for people experiencing mental illness in practice. Transformational frameworks, evidence-based practice and patient-centred approaches have been established and implemented but non-adherence incidence rates continue to rise among people with schizophrenia. Moreover, the relationship between treatment attitudes and adherence in adults diagnosed with schizophrenia remains unclear. DESIGN A scoping review using the framework offered by Implementation Science, 5, 2010, 1. The PRISMA-ScR checklist was used to ensure integrity of the review. METHODS Four databases PsychINFO, Medline, Cochrane and CINAHL databases were searched for literature along with the reference lists of eligible sources. Original research, peer-reviewed articles published between 2010 and 2020 in English language were included. Articles were included if study participants were adults with a diagnosis of schizophrenia or related psychosis. Methodological quality was evaluated using a quality assessment checklist, the Critical Appraisal Skills Programme tool. RESULTS Ten articles were included in the study. Five main themes about treatment adherence emerged from the literature: (i) severity of symptoms, (ii) side effects, (iii) beliefs and attitudes, (iv) insight and (v) support and relationships. CONCLUSIONS This scoping review concluded that attitude influenced adherence to medication in people with schizophrenia. The five main themes reported directly influenced attitude, impacting on treatment adherence in people experiencing schizophrenia. This review makes recommendations for a person-centred and recovery framework that aims to improve adherence. RELEVANCE TO CLINICAL PRACTICE Nurses in all healthcare settings could use evidence-based strategies to enhance treatment adherence in people with a range of physical and mental health conditions.
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Affiliation(s)
- Simehlani Nyanyiwa
- School of Nursing & Midwifery, Western Sydney University, Sydney, New South Wales, Australia.,South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Kath Peters
- School of Nursing & Midwifery, Western Sydney University, Sydney, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Gillian Murphy
- School of Nursing & Midwifery, Western Sydney University, Sydney, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
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Di Lorenzo R, Iorio A, Pinelli M, Magarini F, Marchi M, Sacchetti A, Calogero C, Galeazzi GM, Ferri P, Rovesti S, Minarini A. Effectiveness and Quality of Life with Paliperidone Palmitate 3-Monthly in Comparison with Other Long-Acting Drugs. Neuropsychiatr Dis Treat 2022; 18:829-846. [PMID: 35440870 PMCID: PMC9013412 DOI: 10.2147/ndt.s356341] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/10/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Antipsychotic long-acting injections (AP-LAIs) are indicated for patients affected by schizophrenia especially those with poor treatment adherence. PATIENTS AND METHODS To compare paliperidone palmitate 3-monthly (PP3M), paliperidone palmitate one-monthly (PP1M) and haloperidol decanoate (HAL-D) treatment, we enrolled 90 patients with schizophrenia treated in Mental Health Center with one of the three AP-LAIs for at least six months and followed them for another 6 months. At 6 and 12 months of treatment we administered Clinical Global Impression-Severity, Global Assessment of Functioning and World Health Organization Quality of Life-26 items (WHOQOL-BREF). At 1-year treatment, we evaluated relapses (psychiatric hospitalizations and urgent consultations), side effects and drop-outs. RESULTS We did not highlight any statistically significant difference among the three treatments in relapses and scale scores. Weight increase was significantly higher in PP1M and PP3M groups. Twelve patients (13.3%) discontinued AP-LAI. At 1-year AP-LAI treatment, 69% of patients rated quality of life as "good" or "very good" and 71% declared themselves to be "satisfied" or "very satisfied". CONCLUSION HAL-D, PP1M and PP3M 1-year treatments were similarly effective in preventing relapses and improving quality of life and health satisfaction. All discontinuations in the new 3-monthly antipsychotic treatment were caused by patient refusal to continue it.
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Affiliation(s)
- Rosaria Di Lorenzo
- Service of Psychiatric Diagnosis and Care, Department of Mental Health and Pathological Addictions, AUSL-Modena, Modena, Italy
| | - Anita Iorio
- Psychiatric Rehabilitation Technique Programme, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Margherita Pinelli
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Magarini
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Mattia Marchi
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Sacchetti
- School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Calogero
- Community Mental Health Center, Vignola (MO), Department of Mental Health and Pathological Addictions, AUSL-Modena, Modena, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Ferri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Sergio Rovesti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Minarini
- Community Mental Health Center, Vignola (MO), Department of Mental Health and Pathological Addictions, AUSL-Modena, Modena, MO, Italy
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Gül İ, Yeşiltaş A. Mental wellbeing and perception of health in the era of COVID-19 pandemic: A cross-sectional study in the general population. Perspect Psychiatr Care 2022; 58:97-107. [PMID: 33931871 PMCID: PMC8242898 DOI: 10.1111/ppc.12818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/26/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE This study was aimed at evaluating mental wellbeing and health perception in the general population during the coronavirus disease 2019 (COVID-19) pandemic and at highlighting the correlation between them and selected variables. DESIGN AND METHODS This descriptive and cross-sectional study was carried out in 374 individuals, who were remotely administered two scales ("Perception of Health Scale [PHS]" and "Warwick-Edinburgh Mental Wellbeing Scale [WEMWBS]") and a demographic and clinical questionnaire. FINDINGS PHS mean score was 53.24 ± 7.69 and the total WEMWBS score was 52.95 ± 10.75. A positive statistically significant correlation was found between PHS and WEMWBS (p < 0.05). Gender, marital status, and education levels conditioned mental well-being in a statistically significant. Suffering from a chronic disorder, COVID-19 symptoms, or having a family member affected by COVID-19 infection influenced the health perception. PRACTICAL IMPLICATIONS Exposing the factors affecting the health and mental wellbeing perceptions of individuals, especially during the pandemic period, can guide policymakers.
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Affiliation(s)
- İsa Gül
- Department of Health Management, Faculty of Health Sciences, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Aysun Yeşiltaş
- Department of Health Management, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey
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Moretti V, Brunetti C, Candaten A, Cannavò D, Manfredi M, Maserati M, Piccinini A, Rinaldi M, Artioli G, Sarli L, Ferri P. Take a picture! The role of visual methods in understanding psychiatric patient's everyday life. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021028. [PMID: 34328131 PMCID: PMC8383233 DOI: 10.23750/abm.v92is2.11945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022]
Abstract
Background and aim: Understanding the patient’s experience of mental illness can foster better support for this population and greater partnership with healthcare professionals. This study aims to explore the application of visual methods in the psychiatric field and, in particular, the experience of people suffering from psychotic disorders, because it is still an open question that has not been only partially empirically examined. Methods: This qualitative study was conducted using two visual methods (auto-photography and photo-elicitation) associated with the narrative that emerged from an unstructured interview, in a clinical setting of adult Mental Health in Italy, between October 2019 and February 2020. A total of 5 patients and 5 corresponding referring healthcare professionals were identified and enrolled. Patients were asked to produce photographs following 4 thematic areas: “Fun”, “Time”, “Something indispensable”, “Place where I feel good”. Results: A total of 85 photographs were produced. Visual methods have proved to be a useful technique in qualitative research in the area of adult psychiatry. From the interviews it emerged that visual methods have allowed psychotic patients to use a new language to be able to communicate their emotions. Conclusions: The healthcare professionals involved also confirm the potential of this tool which, when combined with the traditional interview, is able to deepen the patient’s knowledge by overcoming the verbal barriers that often make it difficult to reconstruct the individual experience of illness.
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Warriach ZI, Sanchez-Gonzalez MA, Ferrer GF. Suicidal Behavior and Medication Adherence in Schizophrenic Patients. Cureus 2021; 13:e12473. [PMID: 33552789 PMCID: PMC7854315 DOI: 10.7759/cureus.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Suicide is one of the potential complications in the Schizophrenic patient population. This review article deals with the significance of antipsychotic medication compliance in decreasing suicidal behavior and hospitalizations in Schizophrenic patients. The medication adherence with second-generation antipsychotics (SGA) like clozapine and long-acting injectables (LAIs) like paliperidone is associated with decrease suicidal behavior and all-cause mortality in Schizophrenic patients. Concomitant treatment of depression and substance abuse disorder in this patient population is also associated with decreasing all-cause mortality and hospitalizations. On the other hand, long-term benzodiazepine use is associated with increase mortality in Schizophrenic patients. We also discuss some important physician intervention strategies to improve medication adherence in Schizophrenic patients like motivational interviewing (MI), behavioral tailoring (BT), and psychosocial interventions like cognitive behavior therapy (CBT).
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Affiliation(s)
- Zain I Warriach
- Department of Psychiatry, Larkin Community Hospital, Miami, USA
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Kawamata Y, Sugawara N, Ishioka M, Kubo K, Suzuki K, Fujii A, Furukori H, Nakagami T, Yasui-Furukori N, Shimoda K. Different Attitudes of Patients and Psychiatrists Toward Benzodiazepine Treatment. Neuropsychiatr Dis Treat 2021; 17:1927-1936. [PMID: 34163166 PMCID: PMC8214561 DOI: 10.2147/ndt.s314440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/27/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Concern regarding the benefit/risk ratio of the long-term use of benzodiazepines (BDZs) and Z-drugs is increasing. To prevent the risk of dependence in BDZ long-term use, it is essential to understand the attitudes of patients and psychiatrists toward BDZ treatment. The aims of this investigation were to 1) obtain information on patients' attitudes with long-term BDZ use and their referring psychiatrists' attitudes toward BDZ treatment, including their perception of the difficulty of reducing the dose of BDZs, and 2) identify discrepancies between patients' and psychiatrists' perceptions. METHODS A brief questionnaire was constructed to investigate the attitudes of patients receiving BDZ treatment and their referring psychiatrists. Our sample comprised 155 patients who received BDZ treatment for more than one year and their referring eight psychiatrists. Both the patients and their psychiatrists completed our questionnaire between August 2017 and December 2017. RESULTS Of the patients, 13% felt that it was more difficult to reduce the dose of BDZs than their referring psychiatrists (type A discrepancy), while 25% felt that it was less difficult (type B discrepancy). In the multivariate logistic regression analysis, the female sex and both the patients' ("psychotherapy plus BDZs was necessary" and "it was necessary to increase the dose of BDZs") and psychiatrists' beliefs ("short-term prescription was justified") were associated with type A discrepancies. Type B discrepancies were associated with psychiatrists' beliefs that the patient's wishes justified the use of BDZs and that the cessation of treatment with BDZs would lead to the deterioration of their rapport with their patients. CONCLUSION To overcome the discrepancies in the attitudes of patients and psychiatrists toward the cessation of BDZ treatment, it is necessary to promote patient-centered care involving patient psychoeducation and practice guidelines for the decision-making process. Further studies investigating the promotion of patient-centered care to reduce BDZ use are needed.
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Affiliation(s)
- Yasushi Kawamata
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan.,Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Kazutoshi Kubo
- Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan
| | - Katsuji Suzuki
- Department of Psychiatry, Aomori Central Hospital, Aomori, Japan
| | - Akira Fujii
- Department of Neuropsychiatry, Mutsu General Hospital, Mutsu, Japan
| | - Hanako Furukori
- Department of Neuropsychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan
| | - Taku Nakagami
- Department of Psychiatry, Nakagami Mental Clinic, Ohdate, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan.,Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
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