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Open Access
Article
Publication date: 22 March 2017

Oluseun P. Ogunnubi, Andrew T. Olagunju, Olatunji F. Aina and Njideka U. Okubadejo

Medication adherence contributes significantly to symptom remission, recovery and wellbeing in mental illnesses. We evaluated how medication adherence correlates with…

Abstract

Medication adherence contributes significantly to symptom remission, recovery and wellbeing in mental illnesses. We evaluated how medication adherence correlates with clinico-demographic factors and quality of life (QoL) in a sample of Nigerians with schizophrenia. This descriptive cross-sectional study involved 160 randomly selected participants with confirmed diagnosis of schizophrenia based on MINI International Neuropsychiatric Interview. Data on socio-demographic and clinical characteristics of participants were collected with a questionnaire. Medication adherence was assessed with Morisky Medication Adherence Questionnaire, and participants completed the World Health Organization Quality of Life Scale-BREF. The mean age of participants was 38.54 (±11.30) years, and all the participants were on antipsychotics, but only 45% were adherent to their medication. Out of all the participants, 45 (28.2%) considered their overall QoL to be good, 97 (60.6%) considered theirs to be fair, while 18 (11.2%) reported poor QoL. Medication non-adherence correlated negatively with good QoL across multiple dimensions including overall QoL (r=−0.175), health satisfaction (r=-0.161), physical (r=-0.186) and psychological domain (r=-0.175). Again, participant's age (r=−0.190) and age of onset of illness (r=-0.172) correlated negatively with medication non-adherence, and a trend towards relapse delay with medication adherence was also observed (r=-0.155). The effect size of these correlations were however small. Our findings suggest a link between medication adherence and QoL in schizophrenia, such that strategy that addresses medication non-adherence and its determinants may have potential benefits on wellbeing. Further hypotheses-driven studies are desirable.

Details

Mental Illness, vol. 9 no. 1
Type: Research Article
ISSN: 2036-7465

Keywords

Open Access
Article
Publication date: 8 July 2019

Vanessa Pinfold, Ceri Dare, Sarah Hamilton, Harminder Kaur, Ruth Lambley, Vicky Nicholls, Irene Petersen, Paulina Szymczynska, Charlotte Walker and Fiona Stevenson

The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

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Abstract

Purpose

The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

Design/methodology/approach

The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.

Findings

The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Practical implications

Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

Originality/value

This paper uses data collected in a co-produced research study including peer researchers.

Details

Mental Health Review Journal, vol. 24 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

Open Access
Article
Publication date: 6 December 2018

Nanthakan Woodham, Surasak Taneepanichskul, Ratana Somrongthong and Nanta Auamkul

Hypertension is a common disease among elderly. Adherence to antihypertensive medication is a key predictor of optimal blood pressure control that prevents the risk of…

3217

Abstract

Purpose

Hypertension is a common disease among elderly. Adherence to antihypertensive medication is a key predictor of optimal blood pressure control that prevents the risk of cardiovascular disease and potentially death. The purpose of this paper is to assess adherence to antihypertension and identify associated factors among the elderly in a rural area, Buengkan province, Thailand.

Design/methodology/approach

A health facilities based cross-sectional study was conducted in Buengkan district. A simple random sampling method was used to select 408 participants. A structured questionnaire adapted from the World Health Organization STEPwise approach was used to collect data. The medication adherence level was identified by pill count with percentage ⩾70 defined as good adherence. Descriptive and summary statistics were used. Bivariate analysis was done using Pearson’s χ2 test, and multivariable analyses were also carried out.

Findings

A total of 408 (143 males and 265 females) elderly hypertension patients with uncontrolled blood pressure participated in this study. Most of the participants were found to have lower adherence to medication treatment (86.8 percent), whereas the remaining ones (13.2 percent) were found to have good adherence. The multivariable logistic regression analysis showed that having a daughter as a care taker (adjust odd ratio=7.99, 95% confidence interval: 1.23–51.778) was significantly associated with high medical adherence.

Originality/value

Hypertension medication adherence among elderly patients with uncontrolled blood pressure was poor. Having a care taker, especially a daughter, is a key to improve adherence. Effective strategy to improve adherence should focus on and involve family participation into the program.

Details

Journal of Health Research, vol. 32 no. 6
Type: Research Article
ISSN: 2586-940X

Keywords

Open Access
Article
Publication date: 30 October 2009

Steffen Moritz, Cicek Hocaoglu, Anne Karow, Azra Deljkovic, Peter Tonn and Dieter Naber

Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced…

Abstract

Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis). Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

Details

Mental Illness, vol. 1 no. 1
Type: Research Article
ISSN: 2036-7465

Keywords

Open Access
Article
Publication date: 12 June 2017

Qiong Wu, Zhiwei Zeng, Jun Lin and Yiqiang Chen

Poor medication adherence leads to high hospital admission rate and heavy amount of health-care cost. To cope with this problem, various electronic pillboxes have been proposed to…

2607

Abstract

Purpose

Poor medication adherence leads to high hospital admission rate and heavy amount of health-care cost. To cope with this problem, various electronic pillboxes have been proposed to improve the medication adherence rate. However, most of the existing electronic pillboxes use time-based reminders which may often lead to ineffective reminding if the reminders are triggered at inopportune moments, e.g. user is sleeping or eating.

Design/methodology/approach

In this paper, the authors propose an AI-empowered context-aware smart pillbox system. The pillbox system collects real-time sensor data from a smart home environment and analyzes the user’s contextual information through a computational abstract argumentation-based activity classifier.

Findings

Based on user’s different contextual states, the smart pillbox will generate reminders at appropriate time and on appropriate devices.

Originality/value

This paper presents a novel context-aware smart pillbox system that uses argumentation-based activity recognition and reminder generation.

Details

International Journal of Crowd Science, vol. 1 no. 2
Type: Research Article
ISSN: 2398-7294

Keywords

Open Access
Article
Publication date: 12 February 2018

Kerry Wilbur, Arwa Sahal and Dina Elgaily

Patient safety is gaining prominence in health professional curricula. Patient safety must be complemented by teaching and skill development in practice settings. The purpose of…

Abstract

Purpose

Patient safety is gaining prominence in health professional curricula. Patient safety must be complemented by teaching and skill development in practice settings. The purpose of this paper is to explore how experienced pharmacists identify, prioritize and communicate adverse drug effects to patients.

Design/methodology/approach

A focus group discussion was conducted with cardiology pharmacy specialists working in a Doha hospital, Qatar. The topic guide sought to explore participants’ views, experiences and approaches to educating patients regarding specific cardiovascular therapy safety and tolerability. Discussions were audio-recorded and transcribed verbatim. Data were coded and organized around identified themes and sub-themes. Working theories were developed by the three authors based on relevant topic characteristics associated with the means in which pharmacists prioritize and choose adverse effect information to communicate to patients.

Findings

Nine pharmacists participated in the discussion. The specific adverse effects prioritized were consistent with the reported highest prevalence. Concepts and connections to three main themes described how pharmacists further tailored patient counseling: potential adverse effects and their perceived importance; patient encounter; and cultural factors. Pharmacists relied on initial patient dialogue to judge an individual’s needs and capabilities to digest safety information, and drew heavily upon experience with other counseling encounters to further prioritize this information, processes dependent upon development and accessing exemplar cases.

Originality/value

The findings underscore practical experience as a critical instructional element of undergraduate health professional patient safety curricula and for developing associated clinical reasoning.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Open Access
Article
Publication date: 1 January 1970

Pichamon Poonnotok, Nuchanart Kaewmart, Tanawan Asarath and Wetid Pratoomsri

The purpose of this paper is to describe experiences of caregivers in managing psychotic symptoms of persons with schizophrenia in various circumstances.

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Abstract

Purpose

The purpose of this paper is to describe experiences of caregivers in managing psychotic symptoms of persons with schizophrenia in various circumstances.

Design/methodology/approach

The data were obtained via a focus group and in-depth interviews among caregivers who cared for relatives with schizophrenia for more than five years. Thematic analysis was used for data analysis.

Findings

“Making it better” emerged as the main theme describing caregivers’ experiences in trying to manage psychotic symptoms. It comprises four sub-themes including cutting off the wind, protecting from harm, preventing relapses and pulling back to normality. The caregivers gradually learned and adjusted their strategies through trial and error. They tried to stop aggressive and violent behaviors soon after they had begun by giving cool water to their relatives to drink or shower, while expressing their own affect with gently talking. They also dealt with a hardship in protecting the patients, other people, their properties and their own selves from harm resulting from violent behavior. When the psychotic symptoms improved, the caregivers tried to prevent relapses by using various strategies to maintain medication adherence and by soothing their relatives’ mental state. They also tried to pull their relatives back to normal as much as they could by promoting their relatives’ memories and abilities to perform daily functions.

Originality/value

The findings increase knowledge in nursing regarding psychotic symptoms management. The findings can be applied to the development of a program to help caregivers to manage psychotic symptoms effectively in order to promote good clinical outcomes of patients and alleviate the caregivers’ burden.

Details

Journal of Health Research, vol. 33 no. 3
Type: Research Article
ISSN: 2586-940X

Keywords

Open Access
Article
Publication date: 14 December 2022

Jon Painter, Winola Chio, Liam Black and David Newman

This study aims to understand whether psychotropic prescribing practices for people with intellectual disabilities are in keeping with best practice guidelines.

Abstract

Purpose

This study aims to understand whether psychotropic prescribing practices for people with intellectual disabilities are in keeping with best practice guidelines.

Design/methodology/approach

This service evaluation project was a retrospective analysis of routinely collected data from the care records of all 36 people with intellectual disability discharged from an intellectual disability assessment and treatment unit during the first five years of the Stop Over medicating People with Intellectual Disabilities and/or autistic people (STOMP) initiative. Data were gathered at four time points (pre-admission, discharge, 6- and 12-month follow-up) before being analysed to understand whether psychotropic prescribing differed among people with different clinical characteristics/traits/diagnoses. Changes over time were also explored to ascertain whether and how prescribing altered from admission to discharge, and over the subsequent year of community living.

Findings

Most people with intellectual disabilities left the assessment and treatment unit on fewer regular psychotropic medications and at lower doses than at admission. These optimised regimes were still apparent 12 months post-discharge, suggesting effective discharge planning and community care packages. Inpatients with severe intellectual disabilities generally received more anxiolytics and hypnotics, at higher doses. Autistic people tended to receive more psychotropics in total and at higher cumulative doses, a pattern that persisted post discharge. A third of the sample were admitted on regular anti-psychotic medications despite having no corresponding psychotic diagnosis, a proportion that remained relatively stable through discharge and into the community.

Originality/value

This study highlights subsets of the intellectual disability population at particular risk of receiving high doses of psychotropics and a feasible template for providers intending to undertake STOMP-focused evaluations.

Details

Tizard Learning Disability Review, vol. 28 no. 1/2
Type: Research Article
ISSN: 1359-5474

Keywords

Open Access
Article
Publication date: 19 September 2022

Tyler Aird, Ceara Holditch, Sarah Culgin, Margareta Vanderheyden, Greg Rutledge, Carlo Encinareal, Dan Perri, Fraser Edward and Hugh Boyd

The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute…

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Abstract

Purpose

The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.

Design/methodology/approach

Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.

Findings

The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.

Practical implications

A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.

Originality/value

Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.

Details

Journal of Integrated Care, vol. 30 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 30 March 2021

Blender Muzvondiwa and Roy Batterham

Gweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and…

Abstract

Purpose

Gweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and management of NCDs. Despite numerous initiatives, reorienting health services has been slow in many countries. Gweru District has similar challenges. The purpose of this paper is to explore what the health systems in Zimbabwe have done, and are doing to respond to increasing numbers of NCD cases in adults in the nation, especially in the district of Gweru

Design/methodology/approach

The study employed a descriptive narrative review of the academic and grey literature, supplemented by semi-structured key informant interviews with 14 health care staff and 30 adults living with a disease or caring for an adult with a disease in Gweru District.

Findings

Respondents identified many limitations to the response in Gweru. Respondents said that screening and diagnosis cease to be helpful when it is difficult securing medications. Nearly all community respondents reported not understanding why they are not freed of the diseases, showing poor understanding of NCDs. The escalating costs and scarcity of medications have led people to lose trust in services. Government and NGO activities include diagnosis and screening, provision of health education and some medication. Health personnel mentioned gaps in transport, medication shortages, poor equipment and poor community engagement. Suggestions include: training of nurses for a greater role in screening and management of NCDs, greater resourcing, outreach activities/satellite clinics and better integration of diverse NCD policies.

Originality/value

This research offers an understanding of NCD strategies and their limitations from the bottom-up, lived experience perspective of local health care workers and community members.

Details

Journal of Health Research, vol. 36 no. 3
Type: Research Article
ISSN: 0857-4421

Keywords

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