Communication and adherence of patients at a South African public sector specialist psychiatric out-patient clinic

Abstract

Background: The impact that communication has on adherence, considering outcomes such as patient satisfaction and recall of the content of encounters with health care providers, has been extensively reported on in the literature. The South African Depression and Anxiety Group (SADAG) developed a specific communication intervention program, which was implemented in a local public sector setting. Objective: To investigate the attendance and medication adherence of patients at the specialist psychiatric outpatient clinic of the Helen Joseph Hospital in Johannesburg, before and after the pilot implementation of this program. Methods: Included quantitative and qualitative methodologies. The retrospective component included a review of participants' demographic and clinical profile and medication adherence. The prospective, qualitative component included structured pre-and post-questionnaires. Results: The typical participant was female (76%), older than 40 years (58.2%) and unemployed (74.2%). Comparing the study and control groups, the communication program resulted in a higher post-intervention booking ratio for the Study group, while the diagnostic category of participants were associated with their understanding of their medication. Discussion: Being mindful of the noted limitations of this pilot project, the SADAG program or similar communication intervention strategy, should be a standard operational procedure in local South African state sector clinics.

Attitude and preferences towards oral and long-acting injectable antipsychotics in patients with psychosis in KwaZulu-Natal, South Africa

“…In the same study, 13% of participants reported that the reason for their non-adherence to medication was their perceived reactions to the medication. 18 …”

To improve the communication between a community mental health team and its service users, their families and carers

“…an online website with information; monthly newsletters; and free support groups in different regions. 2 It was found that effective communication not only improved the overall satisfaction but also treatment adherence.…”

“…The impact that effective communication has on patient satisfaction has been widely reported in the literature. [1][2][3][4][5][6][7] Similar projects have been undertaken both nationally and internationally, which have identified the importance of good communication between staff and service users. Saunsbury et al 1 demonstrated that improved communication between phlebotomist and junior doctors was achieved by the introduction of the phlebotomy box.…”

“…It was concluded that good communication between clinicians and service users is the basis of psychiatry treatment which also helps to achieve the clinical objectives in psychiatry. 4 Rensburg et al 2 did a similar study on effective communication and treatment adherence of patients in South Africa public sector specialist psychiatric out-patient clinic. The objectives of this study were to: explore the basic knowledge and understanding of patients’ conditions and treatment prior to the implementation of the proposed communication intervention programme; implement the communication intervention programme (‘reminder and support adherence programme’, RSAP) for an initial period of 3 months; document the experience and views of participants after the implementation of the RSAP; and compare medication and clinic attendance adherence at baseline and after the RSAP intervention.…”

“…The RSAP-focussed communication interventions included weekly phone calls; free telephonic counselling; reminder SMS messages; brochures and information; SMS reminders for workshops, support groups and press notifications; an online website with information; monthly newsletters; and free support groups in different regions. 2 …”