Adherence to Mental Health Treatment

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Overview

Patients' failure to complete a simple prescription course presents a tremendous public health problem and a considerable challenge for practicing clinicians. For those with chronic mental illnesses, non-adherence is an even greater problem than in other patient populations and substantially lowers the possibility of improvement or recovery. Additionally, adherence to treatment is further undermined by impairments in insight that often accompany mental illness. Much has been written about non-adherence across medical specialties. Yet, the topic of non-adherence in psychiatric patients is so common and complex that it merits review in its own right. Using the most up-to-date research available, this book summarizes the current knowledge concerning non-adherence in mental illness, presenting concise, practical information on such topics as the reasons behind medication non-adherence, detection of non-adherence, and the pharmacological and non-pharmacological options available to clinicians to manage non-adherence. The authors review the effectiveness of psycho-education, brief counseling, compliance therapy, cognitive adaptive strategies, reminder electronic monitoring strategies, family therapy, peer support and recovery, and assertive community treatment (ACT), as well as assess the legal issues around patient adherence, including outpatient commitment and Kendra's law. Importantly, the text also addresses the ever evolving role of psychiatrists in managing adherence, focusing on the rapid advances in pharmacology, in light of the new and broadening recovery concept for mental illness. The data is presented in a "ready-to-use" manner, utilizing algorithms, diagrams, tables, and figures to convey helpful information to clinicians in order to improve all aspects of psychiatric patient adherence.

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Editorial Reviews

Doody's Review Service
Reviewer: 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.
From The Critics
Reviewer: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.
From The Critics
Reviewer: 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.
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Product Details

  • ISBN-13: 9780195384338
  • Publisher: Oxford University Press, USA
  • Publication date: 12/8/2009
  • Pages: 128
  • Product dimensions: 4.70 (w) x 7.70 (h) x 0.30 (d)

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