Medication decision-making by persons with serious mental illness

Abstract

The Interaction Model of Client Health Behavior (IMCHB) has been established as a useful model in guiding research and development of individually tailored clinical interventions. The constructs of client singularity, client-provider interaction, and health outcomes guided an examination of medication decision-making by persons with serious mental illness (SMI). Client motivation is discussed as it relates to participation in the client-provider interaction and subsequent medication adherence and quality of life. Decisional control, the specific element of the client-provider interaction that affects medication decision-making, is considered in relation to consumer roles and responsibility for medication management. As psychotropic medications remain the single most effective treatment for reducing the active symptoms of psychosis, this look at medication decision-making may have significant implications for nursing.

Walking a fine line: managing the tensions associated with medication non‐adherence in an acute inpatient psychiatric setting

“…The history of nursing’s responsibility in relation to medication non‐adherence is not well‐documented. Mahone (2004) suggests that administering medication, monitoring for effectiveness, side effects, need for adjustments and addressing medication adherence issues seem to have been the domain of nursing from the beginning of the community mental health movement. Its history probably pre‐dates this, as it carries vestiges of the nurse as doctor’s handmaiden carrying out the paternalistic orders bestowed by the doctor’s authority.…”

Shared Decision Making and Serious Mental Illness

“…The literature reports many factors significant in medication adherence by persons with SMI such as dissatisfaction and unfulfilled expectations, quality of overall health, polypharmacy, cognitive function, literacy level, visual acuity, social support, caregiver availability, immediate physical environment, emergency assistance, access to transportation, individual behavior, interpersonal relationships, historical ideologies, understanding of the drug’s purpose and symptom relief (Mahone, 2004). This review of the literature guided the design of this study to include the constructs of client participation, perceived coercion and decisional capacity with outcomes of adherence behavior and attitudes and QoL.…”

Psychotropic medication adherence in correctional facilities: a review of the literature

“…Motivational interviewing, which has been successfully applied to persons with addictions, is now being used as a framework for medication adherence, in combination with stages of change (Prochaska & DiClemente 1983). Nurses are invested in these strategies, as well as the use of health belief models to support nursing interventions, and are now developing evidence for medication adherence interventions (Mahone 2004, Kozuki & Schepp 2005, Finnell & Osborne 2006).…”