Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions

Hansen, Richard A; Hohmann, Natalie S.; Maciejewski, Matthew L.; Domino, Marisa Elena; Ray, Neepa; Mahendraratnam, Nirosha; Farley, Joel F.

doi:10.1111/jphs.12201

Cited by 6 publications

(7 citation statements)

References 28 publications

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“…Continuity of care is a model that aims to provide coordinated and uninterrupted medical and health services 39 . Studies have revealed that the provision of medical and health services for schizophrenia patients using this model could improve their quality of life, treatment compliance, and rehabilitation trajectory 40,41 . We found that the parents of children or adolescents with schizophrenia demanded continuity of medical care to evaluate the patient's condition and prognosis, and provide therapy and care tips.…”

Section: Discussionmentioning

confidence: 99%

“…39 Studies have revealed that the provision of medical and health services for schizophrenia patients using this model could improve their quality of life, treatment compliance, and rehabilitation trajectory. 40,41 We found that the parents of children or adolescents with schizophrenia demanded continuity of medical care to evaluate the patient's condition and prognosis, and provide therapy and care tips. However, there is a lack of communication between hospitals, primary healthcare providers, and community healthcare facilities.…”

Section: Practical Challenges and Solutionsmentioning

confidence: 99%

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Challenge of parents caring for children or adolescents with early‐stage schizophrenia in China: A qualitative study

Xiu-juan

Luo

Wang

et al. 2020

Perspect Psychiatr Care

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Purpose: To explore the challenges of parents caring for early-stage schizophrenia (ESS) children/adolescents in China. Design and Methods: Thirteen parents of ESS subjects completed semi-structured interviews. Thematic analysis was used to analyze data. Findings: Seven themes emerged from the data: psychological shock and emotional burden; lack of disease knowledge and care skill; poor treatment compliance of the patient; difficulty getting along with the patient; conflict within the family or in the workplace; financial burden; and need sufficient social support. Each challenge was produced and influenced under the Chinese special social context. Practice Implications: Professional support was needed to help patients with schizophrenia to cope with their situation promptly. Education initiatives should focus on mental health to prevent discrimination from society and enable people to recognize the early symptoms of schizophrenia in children. Telemedicine should be explored for application in the treatment of mental illness. Also, a broader nationwide healthcare policy would be needed to help to reduce the individual and societal financial burdens associated with schizophrenia.

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Section: Discussionmentioning

confidence: 99%

Section: Practical Challenges and Solutionsmentioning

confidence: 99%

Challenge of parents caring for children or adolescents with early‐stage schizophrenia in China: A qualitative study

Xiu-juan

Luo

Wang

et al. 2020

Perspect Psychiatr Care

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“…Two practice‐related factors were added which the investigators previously used to successfully target interventions: Presence of high‐risk medications—multiple studies investigating the prevalence of adverse drug reactions resulting in ED visits, hospitalizations, or other markers of morbidity have repeatedly identified specific classes of medications as being “high‐risk” (antiepileptics, anticoagulants, antidiabetics, and medications with a narrow therapeutic index) Number of prescribers—the involvement of multiple prescribers and especially the lack of continuity and/or communication between prescribers has been identified as a risk factor for drug‐related problems in the elderly population …”

Section: Methodsmentioning

confidence: 99%

Evaluation of clinical pharmacy priority scoring methods in an adult medicine residency clinic

Krasniak

Szymaniak

Conn

et al. 2019

J Am Coll Clin Pharm

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Background: Patients with higher clinical pharmacy priority (CP2) scores are more likely to receive a medication recommendation from a pharmacist to resolve an identified medication related problem (MRP) in a family medicine clinic.Objective: The objective of this study was to compare a modified CP2 score to the original CP2 score in an adult medicine residency clinic and assess whether a modified CP2 score more appropriately captured patients in need of recommendations from a clinical pharmacist.Methods: A convenience sample of patients scheduled for visits in an adult medicine clinic had a comprehensive medication review (CMR) performed. All patients had the original CP2 score and modified CP2 score calculated retrospectively. Both versions of the CP2 scores were compared using Pearson correlation. The relationship between a recommendation from a pharmacist and each CP2 score was evaluated using Pearson correlation and t test.Results: In total, 148 patients who received a CMR by a clinical pharmacist were included in the retrospective chart review. Overall, there was a strong positive correlation between the CP2 score and the modified CP2 score (correlation coefficient (r) 0.968, P < 0.001); thus, as the CP2 scores increase, the modified CP2 score increases.Patients with higher CP2 and modified CP2 scores were more likely to receive a recommendation from a pharmacist (P < 0.001 and P < 0.001, respectively). There was a moderate correlation between both scores and number of recommendations made (CP2: r = 0.436 [P < 0.001], modified CP2: r = 0.456 [P < 0.001]) which did not differ significantly. Conclusions:The CP2 score and the modified CP2 score were both associated with pharmacist recommendations in an adult medicine clinic. Refinement of the CP2 score did not better capture patients in an adult medicine residency clinic with a recommendation from a clinical pharmacist. K E Y W O R D Shealth care systems, health services research, medication therapy management, pharmacists, pharmacy service, hospital

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“…The term "medication management" is not consistently defined in the literature and sometimes used as a synonym of medication therapy management, although usually it is more narrowly defined than medication therapy management and stresses clinical collaboration between patient and therapist/treatment team (e.g., Gray et al, 2004;Hansen et al, 2018;Howard et al, 2009). In this study, we use mainly the term "medication management" and stress patient-therapist interaction, but we also address guideline adherence and organizational aspects of medication (see Table 2).…”

Section: Definitionsmentioning

confidence: 99%

“…Having multiple prescribers and co-management of medications may increase the risk of discontinuation in medication management (Hansen et al, 2018) and nonadherence (Farley et al, 2011). Paying attention to side-effects and adjusting to the lowest effective and tolerated dose could decrease nonadherence (Garcia et al, 2016).…”

Section: Possibilities To Improve Adherencementioning

confidence: 99%

Medication management of antipsychotic treatment in schizophrenia—A narrative review

Isohanni

Jääskeläinen

Miller

et al. 2020

Human Psychopharmacology

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Background/Objective: The risk-benefit ratio of antipsychotics in schizophrenia depends primarily on their effect on brain chemistry. An important factor influencing the efficacy of prescribed drugs is medication management, which can be defined as an ongoing process to manage and monitor the recommended use of antipsychotics to facilitate their cost-effective, adherent, and acceptable use. Materials: We reviewed narratively relevant literature that examined the medication management of antipsychotics in schizophrenia based on a search of PubMed, Scopus, Web of Science, PsycARTICLES, and Cochrane in May 2020. We also included controlled interventional studies with a follow-up period of at least 2 years. Result: Based on the previous literature, there is no unified approach for optimal medication management, but multiple useful strategies are presented for individual patients, prescribers, and organizations. Conclusions: Systematic medication management may improve the risk-benefit balance of antipsychotics by achieving the lowest effective dose, minimizing adverse effects, and improving adherence. There is a need for well-designed naturalistic studies and clinical trials to optimize management in schizophrenia.

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Continuity of medication management among adults with schizophrenia and comorbid cardiometabolic conditions

Abstract: Greater antipsychotic adherence for adults receiving prescriptions from multiple psychiatric specialists was counteracted by lower statin adherence and greater risk of ED and inpatient utilization. This may help inform optimal care models for these complex individuals.

Cited by 6 publications

References 28 publications

Challenge of parents caring for children or adolescents with early‐stage schizophrenia in China: A qualitative study

Challenge of parents caring for children or adolescents with early‐stage schizophrenia in China: A qualitative study

Evaluation of clinical pharmacy priority scoring methods in an adult medicine residency clinic

Medication management of antipsychotic treatment in schizophrenia—A narrative review

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