Your moment has finally arrived! Alex Trebek stands before you and the Double Jeopardy Round has just begun. The category on the board is titled “Things that…” Alex reads the answer: “magnets, super glue, and patients.” You shout out “What are Things that adhere?!” and win the Double Jeopardy round by a landslide. Then you wake up… You remember that you are not on the set of Jeopardy and that, by and large, patients don't adhere. Bummer. But, at least you know magnets and super glue generally don't disappoint… You've likely heard much of it before—on average, half of all
Medication adherence is one of the most variable and amendable factors impacting the success of pharmacotherapy. This toolbox provides important resources used to evaluate and improve patient adherence. Many of the tools provided may be administered by a practitioner or applied by the patient themselves to better manage medication regimens and improve health outcomes.FOR CLINICIANS/PHARMACISTS
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Many studies have aimed to identify risk factors contributing to medication nonadherence with the goal of developing interventions to improve adherence rates. Several different intervention strategies have been studied. Psychoeducation, cognitive-behavioral therapy, and motivational interviewing have all positively influenced medication adherence and combinations of these approaches may bring about better results than one approach alone. In addition, pharmacists' intervention through answering patients' questions, performing follow up phone calls, offering additional education, and changing of medications or doses, may help the patient and ultimately lead to an increase in medication adherence and disease state improvement.
Medication nonadherence is a large contributor to inadequate therapeutic outcomes, especially among patients with mental illness and carries a high cost. Intervention strategies to increase adherence have incorporated technological advances, including electronic symptom monitoring and communication systems for patients and providers. This article presents a review of several studies demonstrating how technology may affect medication adherence.
Patients with psychiatric illness often have difficulty following a medication regimen. Rates of adherence among patients with schizophrenia are between 50–60 percent; and among those with bipolar affective disorder, the rates are as low as 35 percent.1 Some common barriers to adherence are under the patient's control, so attention to them through education is an important step towards improvement. Complex medication regimens, side effects of medications and lack of consideration of the patient's lifestyle or cost of medication are further contributors to nonadherence.2 Psychiatric patients who are nonadherent or excess fillers of prescriptions are 70 percentINTRODUCTION
Psychiatric pharmacists make a constant effort to improve patient's psychiatric outcomes while minimizing the untoward side effects that can occur as a result of taking psychiatric medications. Once patients show an adequate response, and ultimately remission, of psychiatric symptoms, many may conclude that patients will continue improvement for the foreseeable future. Those who have experience with psychiatric pharmacotherapy know otherwise. Medication adherence is the ultimate long term goal in both the medical and psychiatric populations in order to maintain sustained illness remission; however, it is known that adherence rates are far below what is optimal.1 It has been
Assertive Community Treatment (ACT) is an intensive, community-based psychiatric service developed by a team of researchers at the Mendota State Hospital in Wisconsin.1 It was initiated during the movement of deinstitutionalization in the 1960s, allowing for an increase in hospital discharges from state operated institutions into community-based programs. The research team derived ACT from the inpatient psychiatric treatment team model and proposed ACT to be a “hospital without walls.”2 In addition, the research team hypothesized that providing 24-hour mental health services to newly discharged clients would reduce the amount of rehospitalizations and psychiatric symptom relapses. Since
A Beautiful Mind is a powerful account of the life of Nobel Prize winner and mathematician John Nash. The movie depicts Nash's journey through life with schizophrenia. Nash displays many characteristic symptoms of schizophrenia, including hallucinations, delusions, fear of persecution, and lack of interpersonal relationships. In the beginning of the movie, Nash is an introverted, focused young man searching for the perfect original idea as a graduate student at Princeton's competitive math department. Even then it is apparent that Nash is different from his colleagues; he does not follow social cues and therefore does not have manySTUDENT PERSPECTIVE
In my letter last month, I described CPNP's current activities involving seeking provider recognition and reimbursement for pharmacists and the Board of Directors' Strategic Planning Retreat. Activity on both of these fronts made January an extremely busy month. In early January, the Comprehensive Medication Management Reimbursement (CMMR) Task Force met with ACCP representatives to discuss how we might partner with ACCP in their initiative to achieve provider recognition. It was a productive, positive meeting. Our discussions continue and we will be evaluating partnership options in the next few weeks. As many of you know other pharmacy organizations and other professional
Jacquelyn E. Canning, PharmD, BCPP Assistant Professor of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, CPNP Program Committee Member In the world of psychiatry, it is difficult to find a clinician without a story of a patient successfully treated with a medication regimen who is later hospitalized upon discontinuation of their medications. Within this ever-changing medical climate, providers search for innovative ways to increase medication adherence. The benefits of patient compliance with appropriate treatment regimens have been well documented in the literature with the positive results ranging fromMEDICATION INTEREST MODEL (MIM) FEATURED AS ANNUAL MEETING KEYNOTE TOPIC