A Cross-Sectional Study of Patients' Perspectives on Adherence to Antipsychotic Medication

Patel, Maxine X.; Zoysa, Nicole de; Bernadt, Morris; David, Anthony S.

doi:10.4088/jcp.v69n1004

Cited by 60 publications

(50 citation statements)

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“…It involves poor treatment adherence [27,28,29,30], forming a therapeutic alliance [31], and responding to cognitive behavioural therapy [25,32] and fitness to plead . [19].…”

Section: Connections Between Insight and Incapacitymentioning

confidence: 99%

Acceptance and insight: incapacity to give informed consent

Staden¹

2009

Current Opinion in Psychiatry

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Outline• Abstract • Introduction• Causal connection between mental disorder and particular inabilities• Insight, acceptance and appreciation in assessments of capacity to give informed consent • Connections between insight and incapacity• From insight to acceptance in capacity assessments • Conclusion• References and recommended reading AbstractPurpose of review: To highlight areas for potential refinement in assessments of capacity to give informed consent. Recent findings:The clinical assessment of the patient's capacity to give informed consent may be informed and guided by sophisticated criteria or assessment instruments. The approach of most assessment instruments and the literature on (in)capacity departs from the abilities that underpin giving informed consent. This approach may be refined, however, by assessing clinically for a causal connection between the mental disorder in the mind of a particular person and the particular inability. It may furthermore be refined by assessing that aspect of insight that is best connected to incapacity, for insight has been found to be the best clinical discriminator of capacity status in patients with psychotic and manic disorders. Summary:To find that a person is incapable by virtue of a mental disorder, a causal connection between the mental disorder and the particular inability should be assessed clinically for the very patient.Furthermore, the term 'acceptance' is more apt than 'appreciation' and 'belief' in capturing that aspect of insight by which a person with psychotic and manic disorders may be rendered incapable of giving informed consent.

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“…It involves poor treatment adherence [27,28,29,30], forming a therapeutic alliance [31], and responding to cognitive behavioural therapy [25,32] and fitness to plead . [19].…”

Section: Connections Between Insight and Incapacitymentioning

confidence: 99%

Acceptance and insight: incapacity to give informed consent

Staden¹

2009

Current Opinion in Psychiatry

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“…Injection site pain is less often encountered in SGA LAI treatment compared to FGA LAI (Bloch et al, 2001) and so LAI treatment might already have become somewhat more attractive to patients. Nevertheless, patients inexperienced with LAI treatment do report a high level of fear of injection pain (Patel et al, 2008) contributing to some patients' hesitation or refusal to choose LAI treatment in general.…”

Section: Discussionmentioning

confidence: 96%

Patients' acceptance of the deltoid application of risperidone long-acting injection

Heres¹,

Froböse²,

Hamann³

et al. 2012

European Neuropsychopharmacology

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“…Do communication patterns provide information about potential root causes for the relatively low patient acceptance rate of long-acting therapies when offered by psychiatrists to persons with schizophrenia? [9][10][11][12][13][14][15][16][17][18] This observational, ethnographic study explored these questions by examining the physician's offer of a LAI antipsychotic as an alternative to oral antipsychotic medication to patients with schizophrenia.…”

Section: Methodsmentioning

confidence: 99%

“…This therapy represents a potentially effective solution to the pervasive problem of medication nonadherence in schizophrenia, yet LAI therapy is used relatively infrequently. [9][10][11][12][13][14][15][16] Recognizing that there may be many reasons for underuse of LAIs, the question we seek to answer is whether this low utilization stems from reluctance on the patient's part to accept the recommendation or ambivalence on the part of the practitioner to optimally recommend the specific intervention.…”

mentioning

confidence: 99%

The Challenge of Offering Long-Acting Antipsychotic Therapies

Weiden

Roma

Velligan

et al. 2015

J. Clin. Psychiatry

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Objective:To characterize patterns of communication in the offer of long-acting injectable (LAI) antipsychotic medication made by psychiatrists to patients with schizophrenia by (1) examining the style and content of their interaction and (2) determining how these may have driven the ultimate response to recommendations for LAI therapy. Method:This was an observational study conducted at 10 community mental health centers in 3 waves from July 2010 to May 2011. The final dataset for discourse analysis was 33 recorded conversations in which a psychiatrist offered an injectable antipsychotic to a patient with schizophrenia. These visits were transcribed and analyzed by a team of linguists and social scientists. Results:Our primary finding is that, based on analyses of their language during the interview, psychiatrists presented LAI therapy in a negative light. Supporting this, 11 of 33 recommendations (33%) were accepted during the discussion, whereas in the postvisit interview, 27 of 28 patients (96%) who seemed to decline the initial recommendation said they actually would be willing to try LAI treatment. Conclusions:These data support a preliminary hypothesis that the relatively low use of injectable antipsychotic therapies in the United States relative to other parts of the world is not fully attributable to patient rejection of the injectable modality. Rather, psychiatrists' ambivalence regarding the value of LAIs may play a significant role in the perceived difficulty with patient acceptance of this recommendation.

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A Cross-Sectional Study of Patients' Perspectives on Adherence to Antipsychotic Medication

Cited by 60 publications

References 0 publications

Acceptance and insight: incapacity to give informed consent

Acceptance and insight: incapacity to give informed consent

Patients' acceptance of the deltoid application of risperidone long-acting injection

The Challenge of Offering Long-Acting Antipsychotic Therapies

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