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Doody's Review ServiceReviewer: Steve Paschos, MD (Rush University Medical Center)
Description: This multiauthored collaboration addresses the problem of medication adherence among patients with mental illnesses.
Purpose: It is intended as a concise guide with algorithms, diagrams, tables, and figures of clinically relevant practical information for clinicians. It breaks down the reasons behind, and detection of, nonadherence as well as pharmacological and nonpharmacological options for this serious problem.
Audience: The book is written for psychiatric clinicians who prescribe psychotropic medications in the mental health treatment setting.
Features: Chapter 1 defines adherence and delineates the differences that mental illness makes in the struggle for treatment adherence as compared to other illnesses. The second chapter breaks down nonadherence in specific psychiatric disorders. Chapter 3 explores factors that lead to nonadherence and chapter 4 describes methods to monitor nonadherence with the resources included in the appendix. Chapters 5 and 6 discuss pharmacologic and nonpharmacological methods to manage nonadherence, among them psychoeducation, brief counseling, compliance therapy, cognitive adaptive strategies, and family therapy. Finally, the book concisely reviews legal issues surrounding patient nonadherence to treatment as well as outpatient commitment. The final chapter is a helpful psychiatric adherence toolkit with many useful tables, resources, questioners, rating scales, websites, and labs.
Assessment: This is an excellent, concise, quick read on an all too important topic that is frequently mentioned but not fully addressed. The tables, figures, and diagrams are very helpful in comprehending and teaching the material. Excellent references end each chapter. As an internal medicine/psychiatry PGY-4 resident, I found it interesting to compare and contrast nonadherence in internal medicine with nonadherence in mental illness. This reasonably priced book is a must for every psychiatric clinician.