Mental Health Clinician Volume 2: Issue 4

Patients with psychiatric disorders have high rates of medication nonadherence. Though there are many factors that contribute to medication nonadherence, lack of patient understanding about how to manage medication-related problems when they occur is associated with medication discontinuation. This article describes the importance of teaching patients to solve medication-related problems and discusses the scientific evaluation of such a practice.

Medication nonadherence contributes to lack of achievement of desired therapeutic outcomes. This article reviews the evidence supporting patient education as a one of the tools to promote medication adherence. Patient education and provision of tools to help patients overcome adherence barriers are effective ways to improve medication adherence.

Introduction: Psychiatric pharmacists lead groups for patients with mental health disorders in a variety of locations. It is unknown whether these groups are effective in increasing patient knowledge and adherence or reducing negative healthcare outcomes. It is also unclear whether certain modalities of pharmacist-led medication education groups are more effective than others.

Methods: A literature search using MEDLINE and PsycINFO was performed using the search terms “medication,” “patient education,” “pharmacy” or “pharmacist,” and “psychiatric” or “behavioral” or “mental.” Full text articles of randomized controlled trials or those with a pre-post study design that reported outcomes of a pharmacist-led or coled medication group were included.

Results: Six studies were included in the review, many of which were limited by small sample sizes and confounding factors. These studies suggest that pharmacist-led group medication education can improve cardiac risk factors in patients with diabetes, increase inhaler medication compliance in patients with asthma or chronic obstructive pulmonary disease, and improve the ability of pediatric patients and their parents to manage asthma. Elderly patients' ability to manage their medications improved in one study, but was only shown to be significant for patients using four or more medications in another study. Appropriate medication use by psychiatric outpatients was significantly improved with a pharmacist intervention while decreasing total drug and salary costs.

Discussion: Group interventions provided by pharmacists can be successful in improving patient care outcomes for a variety of disease states in diverse patient populations such as pediatrics and geriatrics. Further research is needed to evaluate the full impact of pharmacist-led medication education groups on outcomes such as patient attitudes, knowledge, patient ability to self-manage medications, adherence, and utilization of health care resources.

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