Factors That Complicate Adherence to Medication-myassignmenthelp

Question: Write about theFactors That Complicate Adherence to Medication. Answer: Introduction This essay explores health factors that might complicate a mentally ill person from not complying to a prescribed medication. It focuses on a case scenario of George a 27- year old male patient who has had multiple admissions in the past to a local acute mental health service. He (George) is admitted to an acute unit on assessment order due to his non-adherence to Risperidone, a medication he has been prescribed to treat Schizophrenia. In earlier past, George has been diagnosed with Schizophrenia, a condition he has not agreed with nor being comfortable with that is why he prefers to use cannabis to treat his condition rather than the pharmacological medication prescribed by his psychiatrist. Schizophrenia is a severe mental illness that affects how a person thinks, manages emotions and relate to others (Minzenberg Carter, 2012). Although there are different treatments to patients with Schizophrenia, George is prescribed Risperidone, an antipsychotic medication usually taken daily e ither in syrup or pill form. George has failed to comply with the medication because he believes cannabis works in his favour than Risperidone. According to Minzenberg and Carter, (2012) adherence to medications is vital for the alleviation of psychotic symptoms associated with schizophrenia such as distorted thoughts, paranoia, hallucinations and feelings of fright. Factors that Might Complicate Georges Compliance to Medication Non-adherence to medication is a complex as well as a multidimensional health care challenge that has been witnessed by George during healthcare delivery. Gearing et al., (2011) holds that the decision on whether to take prescribed medications or not by the people with schizophrenia is a hard phenomenon involving different patients plus medication related facets. For the patient related factors, they include population characteristics such as drug and substance abuse as it is evident in the case of George using Canabis, alcohol dependence, those newly starting the treatment, younger age at the outset of illness, and low-level involvement in the social activities (Gearing et al., 2011). Another great contributor to poor adherence to medication is a membership to the minority ethnic sects. Belief about illness and treatment are also other crucial factors that determine adherence to medication. For instance, adherence to medicines is higher among individuals with schizophrenia who are i nsightful and aware of the purpose of drugs to alleviate symptoms of an illness or shun from being admitted to the hospital. This is evident in the case scenario where George prefers to user cannabis than the recommended medication. According to him, he believes that cannabis can suppress pain and be used to cure illnesses rather than the prescribed Risperidone. Also the attitude towards mediation and belief that medications are much effective in lowering symptoms is another aspect that contributes to adherence to medicines. Intolerable symptoms and side effects are another health factors that might complicate Georges compliance to the prescribed medication. For instance, adverse effects due to antipsychotics such as prolactin levels sedation and extra pyramidal symptoms are somehow problematic. On the other hand, adverse metabolic effects of typical antipsychotics such as an increase in body mass index also contribute to non-adherence to medications (Teter et al., 2011). According to research, understanding the benefits of taking medication to alleviate problematic psychotic symptoms helps to improve willingness to allow the side-effects burden for mental wellness. Lots of research holds to the fact that the need for strong plus active therapeutic relations is vital for the promotion of adherence to medication. Other studies also suggest that therapeutic alliance is highly connected to medication adherence among the persons with Schizophrenia. On the same note, other studies suggest that lack of adherence to medication among people increases with the low level of therapeutic alliance among individuals with schizophrenia (Subotnik et al., 2011). Research also points out that mentally ill people value help from pharmacologists about medication especially when they provide them with information concerning the adverse effects of the drugs show a good understanding of the persons perspective as well as listens to the patients grievances regarding the medication (Velligan et al., 2010). Also, the experience of admission to the health centers is another crucial factor that determines willingness to take medics; lack of involvement in decision making w hen treating the patients, negative pressure when entering the health centers and the aspect of coercion are all connected to the lack of adherence to medications as Velligan et al, (2010) suggests. Studies also show that people having a small extent of illness awareness, as well as of a disease are much likely to demonstrate poor/lack of compliance to medication. Moreover, beliefs and perceptions towards adhering to drugs is also based on earlier experiences, socioeconomic and cultural aspects are also associated with lack of compliance to medication. According to Dunbar-Jacob et al., (2012) these factors may result in the fact that the younger the age, the earlier the age of onset of schizophrenia and the shorter the lifespan of illness, the poorer the compliance rates become. Nursing strategies to assist George Gain better adherence to his prescribed medication The problem of patients non compliance to medication has been widely researched and the rates of lack of compliance have not changed much for the past decades (Australian, 2017). For the case of George, Nurse should adopt the following strategies to help him gain better compliance to medication. Simplifying regimen characteristics. Although patients usually misinterpret medication instructions, nurses should use simple language and have the patient repeat the instructions for proper understanding (Gearing et al., 2011). For the case of George, the nurse can use compliance aids to assist him organize his medication such as medication boxes and alarms to recall dosage times. The Nurse can also use microelectronic kit to know whether George has been taking the drugs as per the prescription. Patients like can also use instruments made to boost physical dexterity especially when administering injections. Imparting crucial knowledge According to research, many patients do not understand prescription instructions and usually forgets lots of what their nurses tell them. To solve this problem, the nurse should provide George with education by limiting instructions to key points in every discussion, and use simple language particularly when giving instructions or explaining diagnosis. Another key thing here would be to involve Georges Family and friends as well as emphasize on the key points discussed. Modify Patients Beliefs/human behavior For complex interventions that require lifestyle changes, it is vital to address the patients intentions, beliefs, and the ability to perform an action. This is due to the fact that knowledge is not enough to boost compliance in recommendations pertaining complex behavior change (Bosworth et al., 2011). The nurse would optimize Georges behavior change by ensuring that he perceives his medical condition to be serious, have channels to address his fears/concerns and see him as having requisite skills needed to perform health behavior. Evaluating adherence Ideally, physicians underestimate the issue of lack of compliance in patients. When a nurse cannot detect non compliance, it becomes difficult for her to correct the problem. Therefore, it becomes hard to measure as well as evaluate patient compliance reliably. The nurse can achieve this through self reports, drug counting as well as urine and serum drug levels. Moreover, the physician should ensure regular examination of the patient to increase his adherence to medication. Counseling A comprehensive dialogue of the merits and demerits of a prescribed medication during patients consultation is regarded as the foundation for the growth of medication compliance (Di Matteo et al., 2012). In this case motivational interviewing can be very helpful to frame a discussion of the patients fears, treatment rationale and social pressure. Hardeman et al., (2010) holds that the value of the patients choice need to be strengthened and rules for the pills consumption be in written formats. Moreover, the aspect of reminders also comprises of the patients family, the nurse and the pharmacologist. A patient needs not to be given the information alone about the effects of a certain medication, the dosage and time of intake, but also be provided with information regarding the meaning as well as chances of side effects and interactions (Gearing et al., 2011). Compliance to medication needs to be discussed every time the patient goes back to the therapist as much as possible. For examp le, this can be done by requesting the patients to submit the medical joint boxes for discussion and joint inspection. Studies have shown that forgetfulness is an integral element leading to lack of compliance. This is an explanation for the study that many effects of counseling are transient and the challenge is to implement continuous counseling technique. According to Di Matteo et al., (2012) telephone counseling as a measure to boost medication compliance has been shown very useful in a two-year randomized controlled trial in more than 400 non-adherent patients receiving four or more drugs prescribed for the treatment of a chronic disease Therapeutic approaches Successful treatment is all about engaging the patients in a healthcare process according to their psychiatric diagnosis as well as cognitive level. The five As of a basic outpatient care are approachability, availability, appropriateness, affordability, acceptability. According to Bubalo et al., (2010) caring for a person with a chronic condition cannot happen unless a health care officer is readily accessible. Afternoon hours may work well for patients who do not prefer morning visits especially when circadian rhythms are not properly aligned. In case the nurse is not approachable, he cannot be successful in handling patients intimate plus complicated mental disorders over a long time (Bosworth et al., 2011). Besides, it is hard to establish a beneficial alliance when the patient finds it hard to see the physicist.c Conclusion The chronic aspect of mental illnesses like schizophrenia calls for a regular engagement between the person with schizophrenia and the treatment staff. Transparency when sharing information, communicating or involvement in decision making is critical to the establishment of treatment decisions that can help a patient in his/her personal goals. Since nurses are some of the most trusted healthcare professionals, skills and expertise at soliciting clients beliefs and perceptions for a plan of care are vital, and psychiatric healthcare staff are in the utmost position to educate the patients about the need for shared decision making in conjunction to the prescribing pharmacologist. Most importantly, helping a schizophrenia person identify his/her medicine, choose targeted psychological interventions as well as select a medication that best suits his lifestyle and objective are some of the strategies that can boost adherence to medication. In the case study presented, George admitted to n ot taking the prescribed antipsychotic Risperidone. In an attempt to treat his conditions he (George) chose to use cannabis which he was positive it could cure his condition. All in all, psychiatric health officers and pharmacologists need to educate people with schizophrenia about the need for adherence to medication. References Australian, R. 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