Medication management remains one of the most complex aspects of care for individuals with severe mental illness (SMI), with new research shedding light on the challenges and potential solutions to improving adherence and effectiveness. A recent study has highlighted the importance of a person-centred approach, arguing that optimising medication use requires collaboration between patients and healthcare providers from diagnosis to long-term management. The findings were published in the journal BMJ Quality & Safety.
SMI, which includes conditions such as schizophrenia, bipolar disorder, and non-organic psychosis, affects millions worldwide, often requiring lifelong medication. While these treatments are essential, they are also associated with significant side effects, including weight gain, diabetes, and cardiovascular disease. Managing these risks while ensuring that patients adhere to their prescribed medication is a persistent challenge, with non-adherence rates reaching as high as 50% in some cases. The study found that one of the primary reasons for this is a lack of shared decision-making and trust between patients and clinicians.
The research identified key factors that contribute to successful medication optimisation. A core finding was that involving patients in decisions about their treatment improves adherence and overall well-being. Shared decision-making, in which practitioners actively engage with patients about their preferences, concerns, and experiences, was shown to foster a sense of agency and trust. However, the study also revealed that many healthcare professionals struggle to implement this approach effectively, often due to time constraints or ingrained prescribing habits.
Another major concern raised by the study is the role of overprescribing. Many patients with SMI are given multiple medications, sometimes at high doses, in an attempt to manage symptoms. This can lead to unnecessary side effects and increased reluctance to adhere to treatment. The study suggests that a more tailored approach, focusing on the lowest effective dose and regular reviews of medication regimens, could improve outcomes.
Cultural and ethnic disparities in medication management were also highlighted as a critical issue. Individuals from ethnic minority backgrounds were found to experience higher rates of non-adherence, often due to mistrust of healthcare providers or a lack of culturally sensitive care. The study recommends targeted interventions, including the use of peer support workers—individuals with lived experience of SMI who can bridge the gap between patients and clinicians.
Transitioning from hospital care to community settings was identified as another vulnerable period for patients. Many individuals struggle with medication management after discharge, leading to increased relapse rates. The study suggests that enhanced support during this period, including follow-up appointments and accessible information on medication, could reduce the likelihood of hospital readmission.
The research underscores the urgent need for systemic changes in mental health services. Practitioners must be equipped with the skills and resources to implement person-centred care, while policymakers should prioritise strategies that promote shared decision-making and cultural competency. Medication is a cornerstone of treatment for SMI, but without a collaborative approach that respects patient autonomy, adherence will remain a significant hurdle.
This article was written by Psychreg News Team from www.psychreg.org
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