Evaluation of an instructional program for improving medication compliance for chronically mentally ill outpatients. A method for decreasing patients' medication errors. The effects of a psychiatric patient education to medication program on post-discharge compliance The Effect of Forewarning on the Occurrence of Side-Effects and Discontinuance of Medication in Patients on Dothiepin A controlled study of education about drug treatment in schizophrenia. Information, compliance and side-effects: a study of patients on antidepressant medication. Informing patients about tardive dyskinesia. Controlled trial of patient education. Drug information for the mentally ill: A randomized controlled trial. The effect of forewarning on the occurrence of side-effects and discontinuance of medication in patients on amitriptyline. Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial Effectiveness of two methods for informing schizophrenic patients about neuroleptic medication. The role of the practice nurse in the management of depression in general practice: treatment adherence to antidepressant medication.
Outpatient medication adherence is a major problem , especially for patients repeatedly hospitalized for psychiatric disorders . This study included 39 such patients who were receiving case management services from a community mental health center . Patients were matched and r and omly assigned to receive in a single session either ( 1 ) information regarding medication and its benefits , ( 2 ) guidelines for assuring adherence which encompassed all phases related to pill-taking including filling prescriptions , use of a pill container , transportation , self-reminders , doctor 's appointments and so forth , or ( 3 ) the same guidelines as ( 2 ) above but given in the presence of a family member who was enlisted in support . The results showed that adherence increased to about 94 % after the guidelines were given for both the individual and family guideline procedure , whereas adherence remained unchanged at 73 % after the medication information procedure . These results suggest a practical means for assuring a high level of medication adherence for patients with psychiatric disorders Eighty anxious and eighty depressed patients were assigned r and omly to receiving one of three versions of an information leaflet about their medication , or to receiving no leaflet at all .  Mean medication errors were reduced from 15 to 4 % by provision of suitably constructed leaflets . The results show the practical importance of informing patients about their medication and of paying attention to the difficulty level of any leaflets issued The effect of a structured program of education on subsequent  psychiatric patient compliance with medication-taking was investigated . The subjects consisted of 150 hospitalized patients housed on four acute-care receiving wards and ready for discharge from Fallsview Psychiatric Hospital in Ohio . They were r and omly assigned to one of three groups . Results indicated that subjects who received written information with verbal reinforcement were significantly more compliant than the control subjects . These findings suggest that , if the h and -out is discussed with them , the patients given medication h and outs similar to those used in the study will comply with medication-taking after discharge at a higher rate than those given no h and -out . Implication s of these findings for increased psychiatric patients '  post-discharge compliance with medications are discussed Dothiepin was prescribed for 100 depressed out- patients alternately allocated to one of two groups . Patients in Group A were forewarned about side-effects and patients in Group B were not forewarned . None of the patients had previously received dothiepin . After two weeks the patients were question ed regarding side-effects and continuance with medication . Eighty-nine patients were included in the final analysis . The results failed to confirm the hypotheses that forewarning patients of side-effects causes a greater number of patients to complain of such effects , or that where patients experience side-effects , forewarning is associated with any less frequent discontinuance of therapy . Compared with a previous study with amitriptyline , the results of this study are much closer to statistical significance . This may be due to the lower overall incidence of side-effects with dothiepin and calls for further work with a larger sample of patients BACKGROUND Various problems are associated with schizophrenia which may theoretically lead to impaired educability about treatment . METHOD The Underst and ing of Medication Question naire , design ed to measure knowledge about treatment in schizophrenia , is described and presented . An educational programme based on a specially design ed information booklet was developed . Sixty-four patients with DSM-III-R diagnosis schizophrenia were r and omly allocated to groups receiving none ( control ) , one session or three sessions of education . RESULTS Pre-intervention low levels of knowledge about illness and treatment increased significantly immediately after a st and ard education session . Three education sessions led to significantly greater knowledge gain than one session . There was no significant change in the control group . Only the PANSS negative syndrome score independently and consistently explained a significant proportion of the education effect . The influence on educability of attitudes to education , impaired insight , cognitive impairment and other variables were considered . Three sessions of education led to significantly increased insight , but no change in compliance . CONCLUSIONS Techniques appropriate for educating schizophrenic patients were discussed , and the value of involving patients in education emphasised . A series of patient education sessions is needed to consoli date learning , rather than a single informing process . The strong association between impaired learning and more severe  negative schizophrenic syndrome  emphasises the need for responsible prescribing of antipsychotic treatment in schizophrenia A study was carried out to eluci date whether the improved compliance associated with the provision of verbal and written information about a prescribed drug is due to the specific information or to a non-specific attention-placebo effect . 120 depressed out patients were prescribed dothiepin and r and omly allocated to one of three groups : Group A were given verbal and written information about side-effects ; Group B were given verbal and written information about beneficial effects ; Group C were told only that the drug was being given to treat their depression and received no written information .  Compliance with medication was assessed at 3 weeks and 6 weeks by interrogation and by pill count . At the same time , side-effects were enquired for and their occurrence or non-occurrence noted . No significant differences were found between the groups in the rates of compliance at either 3 weeks or 6 weeks . When Groups A and B were combined to give a total ' information ' group and compared with Group C -- the ' no-information ' group -- the rate of compliance at 3 weeks was significantly higher ( P less than 0.05 ) in the ' information ' group . No significant differences were found between the groups in the rates of reported side-effects at either 3 weeks or 6 weeks . When Groups A and C were combined and compared with Group B ( information about beneficial effects ) , side-effects were found to be reported significantly less frequently ( P less than 0.05 ) in the latter at 6 weeks . Of 175 compliance estimates , 97.7 % gave concordant results for estimation by interrogation and by pill count . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND This paper evaluates the effects on knowledge and clinical stability of an educational intervention about tardive dyskinesia . METHOD Fifty-six patients receiving antipsychotic maintenance completed a question naire assessing their knowledge about tardive dyskinesia . After r and om allocation to either an educational intervention or a control group , their knowledge was reassessed at six months . RESULTS Ninety-five per cent of patients completed the study . The study patients gained significantly more knowledge than the controls , who made modest gains . There were no significant differences in clinical outcome between the groups . CONCLUSION Patients can learn about serious toxic effects of antipsychotic treatment with a low risk of non-compliance . Discussion about tardive dyskinesia is necessary in the process of obtaining informed consent to treatment Drugs play a significant role in maintaining the health of the mentally ill Lack of information is known to be one of the chief reasons for patients ' failure to adhere to prescribed regimens . This study was design ed to evaluate the impact of drug information leaflets for mentally ill patients on knowledge and satisfaction concerning psychotropic drug therapy . We conducted a r and omized controlled trial of 249 adult general psychiatry patients ( 124 in patients and 125 community patients ) , half assigned to the invervention ( i.e. ,  patient information leaflets ;  these patients also received the usual information ) ( n = 120 ) and half receiving the usual information only ( n = 129 ) . The assessment s were made using a semi-structured question naire . The mean total knowledge score was significantly higher with intervention in both acute and community patients . Analysis of individual aspects of knowledge showed a marked lack of knowledge in the areas of side-effects and pre caution s , which improved significantly with intervention . Patients in the community showed a greater awareness of their drug therapy than did in patients . Improvement in knowledge was evident in all diagnostic groups . There was no significant relationship with age , sex , level of education and number of drugs . Overall , 60 % of controls and 79 % of leaflet patients were satisfied with their drug information . Patient information leaflets provided a useful source of reference for the patients and the carers Amitriptyline was prescribed for 100 depressed out- patients , r and omly allocated to one of two groups . Patients in Group A were forewarned about side-effects and patients in Group B were not forewarned . None of the patients had , so far as could be ascertained , previously received amitriptyline . The patients were seen again after two weeks and question ed regarding side-effects and continuation of medication . Ninety-three patients were included in the final analysis . The results fail to confirm the hypotheses that forewarning patients of possible side-effects either causes a greater number of patients to complain of such side-effects or causes less frequent discontinuance of therapy . The results call for similar studies with other drugs Abstract Objectives : To evaluate two different methods of improving adherence to antidepressant drugs . Design : Factorial r and omised controlled single blind trial of treatment leaflet , drug counselling , both , or treatment as usual . Setting : Primary care in Wessex Participants : 250 patients starting treatment with tricyclic antidepressants .  Main outcome measures : Adherence to drug treatment  ( by confidential self report and electronic monitor ) ; depressive symptoms and health status . Results : 66 ( 63 % ) patients continued with drugs to 12 weeks in the counselled group compared with 42 ( 39 % ) of those who did not receiving counselling ( odds ratio 2.7 , 95 % confidence interval 1.6 to 4.8 ; number needed to treat=4 ) Treatment leaflets had no significant effect on adherence . No differences in depressive symptoms were found between treatment groups overall , although a significant improvement was found in patients with major depressive disorder receiving drug doses of at least 75 mg ( depression score 4 ( SD 3.7 ) counselling v 5.9 ( SD 5.0 ) no counselling , P=0.038 ) . Conclusions : Counselling about drug treatment significantly improved adherence , but clinical benefit was seen only in patients with major depressive disorder receiving doses ≥75 mg . Further research is required to evaluate the effect of this approach in combination with appropriate targeting of treatment and advice about dosage . Key messages Non-adherence is a serious problem in the treatment of depression by general practitioners In this study a brief psychosocial intervention delivered by a nurse greatly improved adherence Clinical benefit was apparent only in patients with major depressive episodes on higher doses of drugs Counselling should be targeted at patients with symptoms of at least moderate severity and combined with therapeutic drug This study showed that both a single educational session and an educational review process were effective in increasingstable  schizophrenic patients ' knowledge about the side effects of neuroleptic medication . In addition , neither intervention result ed in clinical deterioration or decreased compliance .  Structured informing processes using printed information and a multiple-choice question naire have several advantages . Allowing patients to read the information while it isbeing read aloud facilitates learning . Physicians can use the st and ardized printed information form to document more precisely what was said to patients during the informed consent process . In addition , the printed information provides a core to which other educational material s may be added . The question naire can be used to assess which information should be reinforced . Printed information may also be translated into other language s , can be review ed by patients at home , and can be shared with relatives and other advisers and support This pilot study demonstrated the feasibility of providing practice nurse support as an adjunct to st and ard general practitioner treatment to patients with depressive disorders prescribed antidepressant medication .  With respect to the measures used and pilot study objectives identified , there were no statistically significant differences between the study groups in treatment adherence to the prescription of antidepressant medication  or in the incidence and severity of adverse events to medication . Large-scale r and omized controlled trials are in progress to assess the effectiveness of practice nurse interventions in the management of depressive illness in general practice
Aim This literature study explores the impact of educational interventions about medicines for psychiatric patients on adherence , knowledge and economic , clinical and humanistic outcomes .