Medication decision making by persons with serious mental illness


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

3208.0: Monday, December 12, 2005 - 1:30 PM

Abstract #110921

Medication decision making by persons with serious mental illness

Irma H. Mahone, MSN, PhD (c), School of Nursing, Univesity of Virginia, 1688 Dudley Mtn Rd, Charlottesville, VA 22903, 4342951463, ih3xn@virginia.edu

Abstract Psychotropic medication remains the single most effective treatment for reducing the active symptoms of psychosis, yet medication adherence rates for persons with serious mental illness (SMI) remain at about 50%. In non-psychiatric chronic illnesses adherence rates have improved with greater shared decision making (SDM) between client and healthcare provider. Self-care concepts have prompted mental health providers to examine adjustment to life with chronic mental illness instead of only addressing illness symptoms. With the idea of recovery in mental health came the focus of quality of life, empowerment of persons with SMI, and participation by the clients. Self-care and health-promotion concepts are central to the concept of SDM and medication self-management in the SMI population. Because of cognitive limitations such as thought disorganization, physical and mental slowing and memory difficulties in persons with serious mental illness, decisional capacity is another variable to consider in medication decision making and may affect the outcomes of medication adherence and quality of life. Perceived coercion has also been identified as a significant variable in the therapeutic alliance, medication and treatment adherence and on long-term outcomes for persons with SMI. This cross-sectional, correlational study of eighty-five persons with SMI will be interviewed one time during a routine clinic visit. Pearson correlational analysis will determine the strength of the relationships among the constructs of perceived coercion, decisional capacity, preference for and actual client participation, attitudes/behaviors to medication adherence and quality of life as they relate to medication decision making in persons with SMI.

Learning Objectives:

Learning Objectives

Through attendance and participation in this presentation the learner will be able to

1) Discuss five significant variables that affect the decision to take or not to take medications for serious mental illness.
2) Identify three obstacles to client participation in treatment decisions.
3) Recognize the role of client participation in the recovery model.
4) Articulate a philosophy of client empowerment through client participation.

Keywords: Mental Illness, Adherence

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation

Access, Utilization, and Costs of Psychotropic Medications

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA