Using a pharmacy-based intervention to improve antipsychotic adherence among patients with serious mental illness.
Schizophr Bull
; 37(4): 727-36, 2011 Jul.
Article
em En
| MEDLINE
| ID: mdl-19933540
ABSTRACT
BACKGROUND:
Similar to patients with other chronic disorders, patients with serious mental illness (SMI) are often poorly adherent with prescribed medications.OBJECTIVE:
We conducted a randomized controlled trial examining the effectiveness of a pharmacy-based intervention (Meds-Help) in increasing antipsychotic medication adherence among Department of Veterans Affairs (VA) patients with SMI. We also examined the impact of Meds-Help on psychiatric symptoms, quality of life, and satisfaction with care.METHODS:
We enrolled 118 patients from 4 VA facilities with schizophrenia, schizoaffective, or bipolar disorder who were on long-term antipsychotics but had antipsychotic medication possession ratios (MPRs) <0.8 in the prior year. Patients were randomized to usual care (UC; n = 60) or the pharmacy-based intervention (Meds-Help; n = 58). We reassessed adherence at 6 and 12 months, at which time patients completed Positive and Negative Symptom Scales (PANSS), Quality of Well-being Scales (QWB), and Client Satisfaction Questionnaires (CSQ-8).RESULTS:
Prior to enrollment, Meds-Help and UC patients had mean antipsychotic MPRs of 0.54 and 0.55, respectively. At 6 months, mean MPRs were 0.91 for Meds-Help and 0.64 for UC patients; at 12 months, they were 0.86 for Meds-Help and 0.62 for UC patients. In multivariate analyses adjusting for patient factors, Meds-Help patients had significantly higher MPRs at 6 and 12 months (P < .0001). There were no significant differences between groups in PANSS, QWB, or CSQ-8 scores, but power to detect small effects was limited.CONCLUSIONS:
Congruent with prior studies of patients with other disorders, a practical pharmacy-based intervention increased antipsychotic adherence among patients with SMI. However, SMI patients may require additional care management components to improve outcomes.
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Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
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Farmacêuticos
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Transtornos Psicóticos
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Esquizofrenia
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Psicologia do Esquizofrênico
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Antipsicóticos
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Veteranos
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Transtorno Bipolar
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Comportamento Cooperativo
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Comunicação Interdisciplinar
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article