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Attitudes towards antipsychotic medication: the impact of clinical variables and relationships with health professionals order super levitra 80 mg on line erectile dysfunction treatment high blood pressure. A large-scale field test of a medication management skills training program for people with schizophrenia order super levitra without prescription erectile dysfunction doctor prescription. Determinants of medication compliance in schizophrenia: Empirical and clinical findings buy discount super levitra 80mg on line erectile dysfunction 45 year old male. The role of the therapeutic alliance in the treatment of schizophrenia: Relationship to course and outcome purchase 80 mg super levitra amex erectile dysfunction of diabetes. S Department of Health and Human Services: National Institutes of Health Glaser, B. Recovery based service delivery: Are we ready to transform the works into a paradigm shift? A survey of patient satisfaction with and subjective experiences of treatment with antipsychotic medication. From compliance to concordance: a review of the literature on interventions to enhance compliance with antipsychotic medication. Delay to first antipsychotic medication in schizophrenia: impact on symptomatology and clinical course of illness. Adverse effects of atypical antipsychotics: differential risk and clinical implications. Why olanzapine beats risperidone, risperidone beats quetiapine and quetiapine beats olanzapine: An exploratory analysis of head-to-head comparison studies of second generation antipsychotics. Compliance with depot antipsychotic medication by patients attending outpatient clinics. Evaluation of factors influencing medication 304 compliance in inpatient treatment of psychotic disorders. Medication adherence: a review of the literature and implications for clinical practice. Medication compliance and health education among chronic outpatients with mental disorders. Medication adherence in schizophrenia: Exploring patients’, carers’ and professionals’ views. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. Impact of present and past antipsychotic side-effects on attitude toward atypical antipsychotic treatment and adherence. Mental health peer support for hospital avoidance and early discharge: An Australian example of consumer driven and operated service. Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomised, controlled trials. Effects of self-medication programme on knowledge of drugs and compliance with treatment in elderly patients. Qualitative Research Design: An Interactive Approach, Second Edition, Applied Social Research Methods Series, Volume 41. Integration and sealing over: clinically distinct recovery styles from schizophrenia. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. Detecting co-morbid substance misuse amongst people with schizophrenia living in the community: a study comparing the results of questionnaires with analysis of hair and urine. Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients. Emerging approaches for treatment of schizophrenia: modulation of glutamergic signalling. Predictors and consequences of adherence with antipsychotic medication in the outpatient treatment of schizophrenia. First episode psychosis and the trail to secondary care: help-seeking and health-system delays. Predicting medication noncompliance after hospital discharge among patients with schizophrenia. Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode. The impact of side-effects of antipsychotic agents on life satisfaction of schizophrenia patients: a naturalistic study. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Patients’ understanding and participation in a trial designed to improve the management of anti-psychotic medication. The meaning and management of neuroleptic medication: a study of patients with a diagnosis of schizophrenia. Evaluation of the factors interfering with drug treatment compliance among Brazilian patients with schizophrenia. Impact of duration of untreated psychosis on pre- treatment, baseline, and outcome characteristics in an epidemiological first- episode psychosis cohort. Reasons for non- compliance to treatment amongst patients with a psychiatric illness. Understanding and Treating Schizophrenia: Contemporary Research, Theory and Practice. Psychopharmacology and Psychotherapy: Strategies for Maximizing Treatment Outcomes. Using drug claims data to assess the relationship of medication adherence with hospitalisation and costs. Poor Antipsychotic Adherence Among Patients With Schizophrenia: Medication and Patient Factors. Neuroleptic dysphoria may be the missing link between schizophrenia and substance misuse. Assessment and treatment selection for “revolving door” inpatients with schizophrenia. Breakthroughs in Antipsychotic Medications: A Guide for Consumers, Families, and Clinicians. A controlled evaluation of psychoeducational family intervention in a rural Chinese community. Symptom severity and attitudes towards medication: impacts on adherence in outpatients with schizophrenia. The research team is interested in finding out about your experiences of taking medication. If you choose to take part, you will be involved in a one-to-one interview with a researcher. You will be asked about your experiences of medication taking and what strategies you believe could be helpful in improving medication taking amongst people with Schizophrenia. The interview should take no longer than 1 hour to complete and refreshments will be provided.
According to a survey of experienced clinicians order genuine super levitra line erectile dysfunction fpnotebook, the recommended duration of maintenance antipsychotic medication therapy varies depending on the severity of schizophrenia discount super levitra 80 mg online erectile dysfunction treatments diabetes. First episode consumers who have gone into remission after the acute episode has resolved are recommended to take medication for 12 to 24 months cheap super levitra 80 mg with mastercard erectile dysfunction 9 code. When a diagnosis of schizophrenia is clearly established by multiple episodes and/or persistent symptoms super levitra 80mg fast delivery erectile dysfunction treatment drugs, longer term or lifetime medication is recommended. For elective dose reductions, it is recommended that medication is tapered gradually at two to four week intervals over a period of several months rather than switching abruptly to the targeted lower dose (McEvoy et al. Dose reduction strategies have been trialled as alternatives to continuous maintenance schedules in several studies, representing attempts to overcome the adverse side effects of antipsychotic medications whilst still treating the symptoms of schizophrenia. Schooler (2004) reviewed research involving two dose reduction strategies; continuous low dose and intermittent or targeted medication. Although the continuous low dose strategy was associated with reduced adverse side effects and improved subjective well-being for consumers, maintenance medication on moderate dose regimes were consistently found to be the most effective in preventing relapse and, thus, were considered to have largely better outcomes for consumers. Targeted or intermittent medication did not prevent relapse and 32 did not exhibit any clear benefits in terms of reducing adverse side effects (Schooler, 2004). It is further suggested that side effects such as tardive dyskinesia are more common in people who are intermittent in their medication-taking patterns and that sub-optimal antipsychotic treatment can potentially result in the emergence of disabling, treatment-resistant symptoms (Perkins et al. Intermittent approaches are, therefore, not recommended unless the consumer refuses continuous medication treatment (McEvoy et al. The interviewees in the present research were all asked to discuss their experiences of taking typical and/or atypical medications, thus, it is hoped that this chapter helps to contextualise interview data. The introduction of antipsychotic medications revolutionised the treatment of people with schizophrenia. Antipsychotic medications are currently available in tablet and liquid forms and short and long-acting intramuscular depot formulations. Whilst the exact mechanism of antipsychotic medications is unclear, it is often proposed that they block dopamine receptors in the brain, thereby targeting the positive symptoms of schizophrenia. Whilst typical antipsychotic medications 33 are still used, they have largely been replaced by atypical medications as the first-line treatment of schizophrenia due to their reported increased efficacy, tolerability and because they have been associated with a lower risk of relapse when compared to typical medications. Thus, there are some inconsistencies in relation to guidelines for indications of typical and atypical medications, in particular, whether atypical medications or both typical antipsychotic medications and atypical antipsychotic medications, should represent the first-line treatment for first episode consumers. Long-acting depot medication is recommended when consumers express a preference for this route and for those experiencing significant adherence difficulties. It typically takes approximately six weeks for the onset of the therapeutic effects of antipsychotic medication. Early initiation of medication treatment amongst first episode consumers has been associated with better outcomes for consumers. Continuous maintenance pharmacotherapy is superior to dose reduction strategies and intermittent, targeted medication regimens in preventing relapse. The benefits associated with continuous maintenance pharmacotherapy support the importance of complete adherence (as opposed to partial adherence) in order to prevent relapse, thus, reinforcing the benefits of research that explores adherence amongst consumers. The following chapter will elaborate the importance of medication adherence 34 amongst consumers, in addition to providing an overview of adherence statistics and factors proposed to influence adherence. Moreover, a continuous maintenance medication schedule can reduce the risk of relapse amongst consumers and is significantly more effective than dose reduction or intermittent strategies. Positive outcomes in terms of symptom reduction and reduced risk of relapse are contingent upon consumers’ adherence to continuous maintenance medication schedules, however. In contrast, non-adherence has been shown to be the most important predictor of relapse and hospitalisation amongst consumers. Despite these negative consequences, rates of non-adherence remain high amongst consumers. Following a brief account of the terminology used to describe the behaviour of medication taking, the following chapter summarises research related to the impact of adherence on symptoms and relapse. Statistics that relate to the prevalence of adherence are then provided, however, they should be interpreted with caution due to the difficulties associated with measuring adherence accurately. This is followed by a discussion of factors proposed to influence adherence in qualitative and quantitative research. An overview of the Health Belief Model, which has been proposed to explain adherence behaviour amongst consumers with schizophrenia, is then presented. By highlighting the benefits associated with adherence for consumers and providing statistics which illustrate how common non-adherence is, the present chapter supports the value of research aimed at improving adherence amongst consumers. Furthermore, the summary of quantitative and 36 qualitative research exploring factors related to adherence, in addition to explanatory models of adherence, provide a comprehensive overview of previous findings. Indeed, there is some overlap with previous findings in the analysis presented in subsequent Chapters 5, 6 and 7. The most commonly used, traditional term is compliance, which has been defined as the extent to which a consumer’s behaviour matches the prescriber’s recommendations (Horne, Weinman, Barber, Elliot, & Morgan. The use of the term compliance is declining as it implies a lack of consumer involvement and, rather, suggests a passive approach whereby the consumer faithfully (and often unquestioningly) follows the advice and directions of the healthcare provider (Horne et al. Inherent to the various definitions of compliance is the assumption that medical advice is good for the consumer and that rational consumer behaviour means following medical advice precisely (Swaminath, 2007). Adherence is defined as the extent to which the consumer’s behaviour matches agreed recommendations from the prescriber (Horne et al. It reduces attribution of greater power to the healthcare provider in the prescriber-consumer relationship and, rather, denotes some collaboration regarding health-related decisions (Swaminath, 2007). Adherence represents an attempt to emphasise that a consumer is free to decide whether to adhere to the health provider’s recommendations and that 37 failure to do so should not be a reason to blame the patient (Horne et al. According to Swaminath (2007), utilising this terminology with the consumer assists in fostering ownership and the continuation of treatment decisions by the consumer. Another new term which is predominantly used in the United Kingdom is concordance. The definition of concordance focuses on the consultation process, in which healthcare provider and consumer agree to therapeutic decisions that incorporate their respective views (Horne et al. The term ‘persistence’ has also been used recently and refers to the act of continuing treatment for the prescribed duration, or alternatively, the duration of time from initiation to discontinuation of therapy (Cramer, 2008). Despite some changes throughout the course of the present research, the term adherence was ultimately used, in line with the increased focus on consumer-centred approaches in healthcare. Interview data which will be discussed in the analysis in greater depth (in particular Chapter 7), however, suggest that the term adherence may not accurately reflect current clinical practice. That is, whilst the term adherence implies increased collaboration between the healthcare provider and the consumer, and suggests that consumers have the freedom to choose whether or not to follow a prescribed treatment regimen, in practice, many consumers perceived a lack of control over their treatment regimens. Indeed, many of the individuals with schizophrenia who were interviewed had not previously heard of the term ‘adherence’ but understood the term ‘compliance’ and used this to describe the degree to which they followed their medication prescriptions. Several studies have shown that illness symptoms are more pronounced amongst individuals with schizophrenia who are non-adherent. Extreme exacerbations in symptoms often lead to a relapse of psychosis for non-adherent consumers and hospitalisation. A recent study, which followed up outpatients with schizophrenia over three years found that symptom remission was more likely to occur in consumers who were adherent to their medication at follow-up (Novick et al.