Medication education is key to helping those who suffer from mental illness. It allows individuals to take back control over their illness and the prescriptions they need for maximum functioning and individual empowerment. Stawar, and Allred (1999) stated, “In the treatment of people with severe and persistent psychiatric disabilities, their willingness and ability to continue with the prescribed medication regimen has long been considered a critical factor in maintaining stability and preventing psychiatric rehospitalization” (p.1-2). Knowing what medications to address and their side effects is important to keeping mentally ill patients/clients compliant. The purpose of medication is to keep the patient/client as “normal” as possible in comparison to the majority of the population in the community.
My senior project was to facilitate a group. The group would help explain the purpose of medication(s) and their side effects to patient/client(s) who were at risk for non-compliance. Through observation at my internship, I have seen the negative effects on patients/clients when medication noncompliance is an issue.
Statement of Need
Stawar and Allred (1999) stated that only 55% of patients/clients who have been prescribed antipsychotic medications were compliant. Overwhelming amounts of patients/clients have reported that the reason they are not compliant with medication(s) are the side effects (Stawar & Allred, 1999). Other major reasons for discontinuing use of prescribed medication was that clients started to feel better and reported concern about monetary cost (Stawar & Allred, 1999).
One of the largest problems I have seen in my internship is that patients/clients are not informed of the purpose of their medication(s) and resulting side effects. Another large problem is that some patients/clients take so many medications that without help filling their daily medication boxes, they do not take the prescribed dosages of their medication(s) correctly.
Description of the Intervention
I evaluated professional literature to find out if medication compliance was a general problem. I found that it is an issue for 45% of the mentally ill population (Stawar & Allred, 1999). There are not many professional journals on medication education and compliance. I found that my task locating literature was more difficult than I had initially thought.
I interviewed two clients with Axis I diagnosis at the public agency I interned for. The first client I interviewed was a female in her thirties with a child under two. The second client I interviewed was a male in his early fifties who had his first break when he was in college. Both use medication(s) to help them function and suppress their auditory and visual hallucinations. The female client had been compliant with her medication(s) for over one year. The male client was never compliant in the 14 months I interned there.
I also interviewed the program manager and the clinical supervisor at my internship sight and found them to be a valuable resource. The clinical supervisor has a Master’s of Psychology and has been working with persons diagnosed with Axis I illnesses for twenty plus years. The program manager stated; “Medication education plays a very important role in transition to independent living” (Program Manager, Oct. 2002). She felt that most clients stop taking medication(s) because they simply feel better and so they must be cured. Stawar & Allred (1999) also stated “reasons for discontinuing use of prescribed medication were they began to feel better and quit taking the medication” (p. 3).
With all of this information, I set out to find a curriculum that would help the clients to better understand why medication compliance is so important to their lives. A case manager at this agency helped me find the curriculum. The program is called “Medication Education Program” and was developed by Kathy Stowell in 1983.
Evaluation of the Intervention
This curriculum has 10 sessions. After the ten sessions, the client reportedly is to be able to understand the importance of medication compliance. They are to also know what their medication(s) are for and the side effects they may expect. The Pharmacy Guild of Australia (1998) emphasized an individual focus for patient/client education. It would be useless to instruct on medication(s) that a client is not taking or may never take.
The curriculum I chose to do my intervention was very thorough. The questionnaires the clients were to fill out were also easy to read. Superior, Broyles, Oliphant, Mack & Thornton (2002) and Kuipers & Davidhizar (1988) found that printed material should be written at a level that patients/clients could comprehend; they found that a fifth to eighth-grade reading level would be understandable to the majority of the population.
I realized I had experienced problems after reviewing the “Medication Education Program”. I was disappointed to find I needed 10 weeks to complete the program with my clients and I would not have enough time. I had begun my senior project in the second semester of my junior year and been working for almost a year. I wanted to complete the intervention and raise the chances of my client’s success. However, due to the limited time, I was unable to complete the 10 week long medication education group.
Reflections on the Project
I am disappointed about the fact that I did not find a curriculum in time to implement the intervention. I did, however, grow as a professional and also learned a great deal. I do know that the case manager who gave me this curriculum has a copy and I hope the group will start the curriculum at that agency. I would suggest to anyone who volunteers to undertake a large plan also have alternate topics for their senior project. I think that it may have been more obtainable if I had a partner to share some of the duties with.
My idea is for other students would be to plan successive goals/tasks for their project. If they complete goal A, then given enough time, move on to goal B. For example, I could have planned first to research and develop a full curriculum. Then, given enough time, implement the curriculum (goal B) and evaluate the results of the implementation (goal C). This would provide superior results for each successive goal and not leave students with an uncompleted project. Regardless, I have gained invaluable knowledge and experience from this wonderful experience.
References
Pharmacy Guild of Australia, (1998). Antipsychotic medications education project. Australasian Psychiatry, 6(1), 35.
Stawar, T.L., & Allred, B.W. (1999). Why people discontinue psychotropic medication: Differences in staff and resident perceptions in an intensive residential treatment program. Psychiatric Rehabilitation Journal, 22(4), 410-413.
Stowell, K. (1983). Medication/education program. Unknown. Unknown.
Superior, C.K., Broyles, J.E., Oliphant, C.S., Mack, G.D., & Thornton, D. (2002). Development and evaluation of a medication education videotape for hospitalized patients. American Journal of Health-System Pharmacy, 59(9), 859-861.
Clinical Supervisor at public agency, Chico. Personal communication. October 2, 2002.
Program Manager at public agency, Chico. Personal communication. October 2, 2002.
Female diagnosed with schizophrenia, Chico. Personal communication. September 30, 2002.
Male diagnosed with schizophrenia, Chico. Personal communication. September 30, 2002.
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