Search results for ‘Subject term:"mental health problems"’ Sort:
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Finding treatment to suit the patient: the Maudsley medication review clinic
- Authors:
- GRAY Richard, REVELEY Adrianne, HOWARD Alan
- Journal article citation:
- Mental Health Care, 2(4), December 1998, pp.132-134.
- Publisher:
- Pavilion
Negative treatment experience and use of drugs with unacceptable side effects are known to reduce patient compliance. The author reports on the first's years operation of a new medication review clinic which believes that patients and carers have a major say in deciding the preferred course of treatment.
Medication adherence in crisis?
- Authors:
- SREENATH San, et al
- Journal article citation:
- Journal of Mental Health, 19(5), October 2010, pp.470-474.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The proportion of referrals who self-reported sub-optimal adherence among 172 referrals to a crisis resolution home treatment (CHRT) service in the North East of England were examined. The study also investigated whether non-adherence was associated with greater likelihood of admission rather than community treatment. The Tablet Routines Questionnaire was used to quantify medication adherence patterns for the month prior to presentation to the CHRT service. Thirty percent of subjects reported suboptimal adherence to prescribed psychotropic medications (less than 70% adherence) in the month prior to the CHRT assessment. These individuals were significantly more likely to have a dual diagnosis and assessment was significantly more likely to be followed by admission. Non-adherence remained a significant predictor of admission when the odds were adjusted for confounders. The authors conclude that clinicians need to proactively identify and manage non-adherence as it is a potentially preventable trigger of relapse often present for months prior to the index crisis referral. Non-adherence is a meaningful target for improving clinical and cost-effectiveness of general adult mental health services.
Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV
- Authors:
- ROYAL Scott W., et al
- Journal article citation:
- AIDS Care, 21(4), April 2009, pp.448-455.
- Publisher:
- Taylor and Francis
The aim of this study is to investigate adherence to highly active antiretroviral therapy (HAART) in persons living with HIV/AIDS (PLWHA) who are homeless or unstably housed. The authors evaluated homeless or unstably housed PLWHA (n=644) in three US cities enrolled in the Housing and Health Study. Using baseline data and controlling for gender, race, age, and education, they examined associations between self-reported two- and Seven-day adherence and access to healthcare, mental health, substance use, and attitudes toward HIV medical therapy. Of the 644 participants, 358 (55%) were currently on HAART. For two-day adherence, 280 (78%) reported missing no prescribed doses (100% adherence), and for seven-day adherence, 291 (81%) reported ≥90% adherence. Logistic regression analyses indicated being younger, not having health insurance, and drug use were associated with missing ≥1 dose over the past two days. Scoring lower on SF-36 mental component summary scale and having greater risk of depression (CES-D) and stress (Perceived Stress Scale) were associated with poorer adherence for both two- and seven-day outcomes. Negative attitudes toward HIV treatment were also associated with lower adherence. Adherence to HIV medications in this population is similar to other groups. Coexisting problems of access to healthcare, higher risk of mental health problems, along with poorer attitudes toward treatment are associated with increased likelihood of missing doses. Comprehensive models of HIV care that include a continuum of medical and social services are essential for treating this population.
Providing recovery services for offenders with co-occurring disorders
- Authors:
- KLEINPETER Christine, et al
- Journal article citation:
- Journal of Dual Diagnosis, 3(1), 2006, pp.59-85.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Providing adequate treatment and supervision for drug offenders with co-occurring disorders in the United States has been a challenge because they are usually not eligible for drug court and often fail to comply with the conditions of probation in other drug diversion programs. The authors report the results of a process evaluation of the Co-Occurring Disorders Court (CODC) implemented by the Superior Court of the County of Orange, California. Drug offenders who are chronically, persistently mentally ill and diagnosed with bipolar disorder, schizophrenia, or a major depressive disorder participated in an 18-month program that provides integrated treatment. Following evaluation by a psychiatrist and the drug court team (judge, public defender, probation officer, and mental health caseworker), they are placed on medication and referred to residential and/or outpatient drug treatment. During the program they are randomly drug tested and their progress is monitored by the drug court team; they receive sanctions for program non-compliance or rewards for program compliance. In the first two years of operation the CODC admitted 72 offenders. The study findings indicate the majority of participants are being stabilized on their medications, which increases their treatment stay and improves their quality of life. At 6 months the participants show advances in social functioning, decreasing problems due to substance use, and productivity in the achievement of life goals. The results of the process evaluation indicate the program is achieving the stated objectives. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Consumer representation in multi-site HIV, mental health, and substance abuse research: the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study
- Author:
- MEYER P.
- Journal article citation:
- AIDS Care, 16(Supplement 1), January 2004, pp.S137-S153.
- Publisher:
- Taylor and Francis
Funders of HIV, mental health, and substance abuse research and services are increasingly mandating substantial consumer representation in the programmes they support. A review of the literature reveals that despite considerable challenges, consumer representation in HIV, mental health, and substance abuse research and services can be extremely valuable, both for the consumer representatives and the programmes they serve. The consumer representation model of the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study is described. Consumer representatives and principal investigators are interviewed about their experiences working within the model. Their collective comments form the basis of recommendations for practice when employing consumer representation models
Viewpoint: we need an alliance not compliance
- Author:
- CHAPMAN Nigel
- Journal article citation:
- Community Care, 23.3.00, 2000, p.15.
- Publisher:
- Reed Business Information
Argues that care in the community for people with mental health problems has never really been properly implemented.
Medication, healing and resistance in East Malaysia
- Author:
- CRABTREE Sara Ashencaen
- Journal article citation:
- Mental Health Religion and Culture, 8(1), March 2005, pp.17-25.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper considers some findings from an ethnographic study of psychiatric patients in hospital care in East Malaysia. The subject of treatment is considered with regard to professional attitudes towards patient 'compliance' and the demonstration of resistance by users within a multicultural context in which traditional healing continues to be a popular alternative to biomedicine. 'Resistance' here is used in its literal meaning, rather than as an abstract, theoretical construct. The narratives of Malaysian patients in relation to resisting treatment in this study form some direct comparisons with, for example, the quotes from service users on the topic of medication, 'control and coercion' in the UK. Resistance to treatment then is interpreted by staff as the outcome of sickness behaviour, which frequently results in coercive strategies. The undisputed power of the medical profession in Malaysia has contributed to the lack of an evolved 'service-user' perspective in which few patient rights are recognised, especially non-treatment. These responses remain embedded in a paternalistic and custodial attitude that does not acknowledge issues of spirituality or alternative healing practices that are important to hospitalised patients. Modernisation of services have not led to a parallel development with regard to patient participation or in terms of appropriate cultural responses. It is concluded that until this takes place professionals will continue to ignore the personal meaning users attach to treatment resistance.
The HIV/AIDS Treatment Adherence, Health Outcomes, and Cost Study: conceptual foundations and overview
- Author:
- HIV/AIDS TREATMENT ADHERENCE HEALTH OUTCOMES AND COSTS STUDY GROUP
- Journal article citation:
- AIDS Care, 16(Supplement 1), January 2004, pp.S6-S21.
- Publisher:
- Taylor and Francis
A growing population of people living with HIV/AIDS have co-morbid psychiatric and substance abuse diagnoses, increasing the need for integrated services for persons with multiple diagnoses. This article reviews models of integrated services for multiply diagnosed persons living with HIV/AIDS. We focus on the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study to highlight the elements of multifaceted and integrated service delivery systems for people with HIV, substance abuse, and mental health disorders. Study organizational features and models of integrated services are discussed, including details of models for assessing mental health and substance abuse, outcomes, and the cost-effectiveness of integrated services.
Review of older people's services in NHS Ayrshire and Arran
- Publisher:
- National Health Service. Quality Improvement Scotland
- Publication year:
- 2003
- Pagination:
- 26p.
- Place of publication:
- Edinburgh
The report found that compliance with the NHS Quality Improvement Scotland Older People’s Quality Indicators is variable and there is evidence of progress towards full compliance in some areas. The inequity of access to services and the need to improve liaison with the different services between North and South Ayrshire should be addressed. The key issuesinclude: input to communities and community hospitals; memory clinics; ortho-geriatric care; liaison with old age psychiatry; and a review of consultant job plans. Consultant geriatricians should be involved in the assessment of all patients being considered for community care assessment to minimise inappropriate placements and reduce the number of moves an individual patient makes. The multi-agency strategy for older people should have an implementation plan with priorities for investment identified and dates for implementation. It should also address the issues raised in this report such as unsuitable accommodation, lack of advocacy services and a review of continuing care, respite and day hospital provision. Bed management issues should be addressed to reduce the number of patient moves.This should include the triage of patients in medical admissions units and the review of beds for continuing care patients in wards shared with those patients whose discharge is delayed. There is a need to audit compliance with the resuscitation policy, the prescribing of ‘as required’ medicines and implementation of the Adults with Incapacity Act.
Drug information sources and antidepressant adherence
- Authors:
- SLEATH Betsy, WURST Keele, LOWERY Tim
- Journal article citation:
- Community Mental Health Journal, 39(4), August 2003, pp.359-368.
- Publisher:
- Springer
The purpose of the study was to examine how patient sources of antidepressant information were related to antidepressant adherence. Eight community pharmacies in central North Carolina participated in the study. A research assistant interviewed eighty-one English-speaking patients who were picking up antidepressant refill prescriptions. Patients most frequently reported receiving antidepressant information from: pharmacists (58%), primary care physicians (50.6%), mental health specialists (40.7%), friends or family members (32.1%), and the Internet (18.5%). Patients experiencing more side effects were significantly less adherent to their antidepressants. Patients who received antidepressant information from more sources were significantly more adherent to their regimen than patients who received information from fewer sources.