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Patients' failure to complete a simple prescription course presents
a tremendous public health problem and a considerable challenge for
practicing clinicians. For those with chronic mental illnesses,
non-adherence is an even greater problem than in other patient
populations and substantially lowers the possibility of improvement
or recovery. Additionally, adherence to treatment is further
undermined by impairments in insight that often accompany mental
illness. Much has been written about non-adherence across medical
specialties. Yet, the topic of non-adherence in psychiatric
patients is so common and complex that it merits review in its own
right.
Using the most up-to-date research available, this book summarizes
the current knowledge concerning non-adherence in mental illness,
presenting concise, practical information on such topics as the
reasons behind medication non-adherence, detection of
non-adherence, and the pharmacological and non-pharmacological
options available to clinicians to manage non-adherence. The
authors review the effectiveness of psycho-education, brief
counseling, compliance therapy, cognitive adaptive strategies,
reminder electronic monitoring strategies, family therapy, peer
support and recovery, and assertive community treatment (ACT), as
well as assess the legal issues around patient adherence, including
outpatient commitment and Kendra's law.
Importantly, the text also addresses the ever evolving role of
psychiatrists in managing adherence, focusing on the rapid advances
in pharmacology, in light of the new and broadening recovery
concept for mental illness. The data is presented in a
"ready-to-use" manner, utilizing algorithms, diagrams, tables, and
figures to convey helpful information to clinicians in order to
improve all aspects of psychiatric patient adherence.
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