Service development
Improving adherence to prescribed medicines
The World Health Organization has described poor adherence to prescribed medicines as 'a problem of striking magnitude.'
In severe mental illness, poor adherence is the greatest and most important cause of preventable psychiatric morbidity. Poor treatment adherence in unipolar depression, bipolar disorder and schizophrenia is known to have a major adverse impact on outcomes.
Improving adherence to treatment is essential if outcomes are to improve. Having access to medicines is necessary but insufficient on its own for the successful treatment of severe mental illness. Low-cost interventions to improve adherence improve the effectiveness of health interventions and produce significant cost-savings.
Without a systematic approach to support adherence, advances in treatment will fail to realize their potential to reduce the burden of chronic illness. Developing interventions to support adherence may have a far greater impact on the health of a population than any improvement in specific medical treatments.
My approach is to offer analysis and synthesis of the best available clinical evidence to underpin the creation of systematic patient-centred interventions.
My multifaceted range of interventions to improve adherence can be tailored to fit with the needs and configurations of individual mental health services. The key components are:
- Engaging patients and carers by involving them as partners in treatment
- Developing high-quality intuitive patient-centred information
- Improving the therapeutic relationship between clinicians and patients and carers
- Providing a formal structured educational intervention for patients and carers