Evaluation of an instructional program for improving medication compliance for chronically mentally ill outpatients
Section snippets
Subjects
The final study sample consisted of 39 subjects selected from the chronically mentally ill patients currently receiving case management and psychiatric outpatient services at a Community Mental Health Center. A total of 49 patients were invited to participate in this research. Of this group, three declined participation and seven were dropped from the study after the intervention was implemented for various reasons: four patients were dropped from the patient+family guidelines condition, one
Demographic comparisons
The three groups of subjects did not differ from each other on any of the demographic or medication-related variables shown in Table 1 (diagnosis, sex, age, etc.) using one-way ANOVAS or χ2 analysis except for a lower number of lifetime psychiatric hospitalizations for the psychoeducational condition (M=2.58, S.D.=1.56) than either the family+patient guidelines (M=7.92, S.D.=5.66) or patient guidelines (M=7.38, S.D.=5.47) conditions (both ps<0.01).
Medication compliance
Table 2 and Fig. 1 show the compliance rates (%
Discussion
The present level of medication compliance of the guideline subjects was near-perfect indicated by the mean of 94% of pills taken or by the 96% of patients taking 90% or more of the pills. The psychoeducational procedure served as a `placebo' control, showing no increases in compliance.
Probable reasons for this high level of effectiveness appear to be the (1) specific nature of the guidelines, (2) the `systems' approach of providing guidelines for all aspects of obtaining utilizing medication
Acknowledgements
We would like to express our appreciation to Apothecary Products, MN who graciously provided the pill containers (Mediset Medication Organizers). We would also like to express our gratitude to the staff of the Nova Southeastern Community Mental Health Center who made this research possible. Specific thanks is extended to Leonard Gralnik, M.D., Rebecca Stevens, Jan Gordon, Leisa Atlas, Janice Curran, Nancy Ion, Fanya Jabouin-Monnay and Pierre Taschereau whose support made the implementation of
References (38)
- et al.
Outpatient alcoholism treatment by disulfiram and community-reinforcement therapy
Journal of Behavior Therapy and Experimental Psychiatry
(1982) What can patient health education coordinators learn from ten years of compliance research?
Patient Education and Counseling
(1987)- et al.
A critical review of interventions to improve compliance with prescribed medications
Patient Education and Counseling
(1987) - et al.
Worksite treatment of hypertension by specially trained nurses: a controlled trial
Lancet
(1979) - et al.
Psychoeducation of partners of bipolar-manic patients
Journal of Affective Disorders
(1991) - Ayllon, T., & Azrin, N. H. (1968). The token economy: a motivational system for therapy and rehabilitation. New York:...
- et al.
Behavioral engineering: the use of response priming to improve prescribed self-medication
Journal of Applied Behavior Analysis
(1969) - et al.
Job finding club: a group-assisted program for obtaining employment
Behavior Research and Therapy
(1975) A strategy for applied research: learning based but outcome oriented
American Psychologist
(1977)Treatment adherence
Journal of Psychiatry
(1976)
The effects of relaxation training with cognitive or non-directive therapy and the role of relaxation-induced anxiety in the treatment of generalized anxiety
Journal of Consulting and Clinical Psychology
Neuroleptic compliance among chronic schizophrenic outpatients: an intervention outcome report
Journal of Consulting and Clinical Psychology
Is noncompliance with outpatient Rx therapy common?
Drug Topics
Controlled trial of depot fluphenazine in out-patient schizophrenics
American Journal of Psychiatry
Medication management
Hospital and Community Psychiatry
Teaching medication management skills to schizophrenic patients
Journal of Clinical Psychopharmacology
Behavioral control of medicine compliance
Journal of Applied Behavior Analysis
Cited by (58)
Patient-Reported Factors Associated With Poor Phosphorus Control in a Maintenance Hemodialysis Population
2016, Journal of Renal NutritionCitation Excerpt :However, little has been recommended in terms of specific content regarding the achievement of sustained phosphorus levels within an adequate range.5 Behavioral approaches have been shown to be effective at reducing unintentional, forgetfulness-related nonadherence, such as providing patients with pill boxes or calendar-based dispensers to help them track their daily medications.33-35 Unfortunately, there appear to be few or no empirical tests of the utility of calendar systems for phosphorus-binding medication among ESRD patients.
Application of telenursing in nursing practice: An integrative literature review
2016, Applied Nursing ResearchDoes Packaging with a Calendar Feature Improve Adherence to Self-Administered Medication for Long-Term Use? A Systematic Review
2011, Clinical TherapeuticsCitation Excerpt :All CBP interventions were pharmacy-filled. Some CPO were filled by the pharmacy,11,18,20,21 some by the patient from vials of loose pills,23,24 and some studies did not identify the filler.19,22 Importantly, the calendar packaging was the sole adherence intervention employed in 7 trials11,17–21,23 but was combined with other adherence-promoting strategies in 1 CBP16 and 2 CPO22,24 studies.
Shared Decision Making and Serious Mental Illness
2008, Archives of Psychiatric NursingRelapse Prevention for Schizophrenia
2007, Therapist's Guide to Evidence-Based Relapse Prevention