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The development and trial of a medication discontinuation program in the department of forensic psychiatry.

Murasugi K, Tsukahara T, Washizuka S - Ann Gen Psychiatry (2015)

Bottom Line: We also categorized 30 questions of the DAI-30 into three subscales: "awareness of the need for medication", "awareness of the effects of psychiatric drugs", and "impression of medication", and examined factors affecting improvement in medication adherence.The total DAI-30 score significantly increased after completion of the MDP (P = 0.002).Our study suggests that the MDP has a possibility of improving medication adherence, and this program might have multidirectional and stimulatory effects on each factor related to the improvement of medication adherence.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, National Hospital Organization, Komoro Kogen Hospital, 4598 Kou, Komoro, Nagano 384-8540 Japan ; Department of Psychiatry, Shinshu University School of Medicine, Nagano, Japan.

ABSTRACT

Background: When treating mentally ill criminal offenders, improving medication adherence is essential to achieving goals, such as long-term stabilization of symptoms and the prevention of recidivism. Most subjects who are treated under the Medical Treatment and Supervision Act have schizophrenia, which is considered a particularly difficult disorder for which to improve medication adherence. For such patients, we developed a Medication Discontinuation Program (MDP) that aims to improve medication adherence by discontinuing antipsychotic drugs and monitoring changes in psychiatric symptoms. We examined whether there was any utility for the MDP on a trial basis as well as whether it would be worthwhile to introduce the MDP to psychiatric programs.

Methods: We conducted the MDP with an intervention group (n = 7) and compared Drug Attitude Inventory-30 (DAI-30) scores before and after implementation of the MDP. We also categorized 30 questions of the DAI-30 into three subscales: "awareness of the need for medication", "awareness of the effects of psychiatric drugs", and "impression of medication", and examined factors affecting improvement in medication adherence.

Results: The total DAI-30 score significantly increased after completion of the MDP (P = 0.002). Significant elevations after completion of the MDP were also observed in the scores for three subscales of the DAI-30.

Conclusions: Our study suggests that the MDP has a possibility of improving medication adherence, and this program might have multidirectional and stimulatory effects on each factor related to the improvement of medication adherence.

No MeSH data available.


Related in: MedlinePlus

Framework of the Medical Treatment and Supervision Act (MTSA).
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Fig1: Framework of the Medical Treatment and Supervision Act (MTSA).

Mentions: The preparation of special treatment systems and facilities is important so that mentally ill people who have committed crimes can be provided with appropriate treatment and avoid recidivism. However, no such system was in place in the late 19th century when scientific medicine was introduced to Japan. More surprisingly, no system was developed in Japan until the early 21st century. Forensic support services in Japan lag far behind those in European countries and the United States, and recently, this need was recognized. As a result, the Act on Medical Care and Treatment for Persons Who Have Caused Serious Cases Under the Condition of Insanity (hereafter, the Medical Treatment and Supervision Act (MTSA)) was signed into law on 15 July, 2005, as the first law pertaining to the treatment and social reintegration of offenders with mental illness in Japan. The purpose of the MTSA is to promote the social rehabilitation of people who have committed serious criminal offenses due to mental disorders. To achieve this goal, subjects are provided with appropriate medical care and continuous supervision to improve their psychiatric symptoms and prevent their recidivism. The framework of the MTSA is shown in Figure 1, and details have been reported previously [1].Figure 1


The development and trial of a medication discontinuation program in the department of forensic psychiatry.

Murasugi K, Tsukahara T, Washizuka S - Ann Gen Psychiatry (2015)

Framework of the Medical Treatment and Supervision Act (MTSA).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4363327&req=5

Fig1: Framework of the Medical Treatment and Supervision Act (MTSA).
Mentions: The preparation of special treatment systems and facilities is important so that mentally ill people who have committed crimes can be provided with appropriate treatment and avoid recidivism. However, no such system was in place in the late 19th century when scientific medicine was introduced to Japan. More surprisingly, no system was developed in Japan until the early 21st century. Forensic support services in Japan lag far behind those in European countries and the United States, and recently, this need was recognized. As a result, the Act on Medical Care and Treatment for Persons Who Have Caused Serious Cases Under the Condition of Insanity (hereafter, the Medical Treatment and Supervision Act (MTSA)) was signed into law on 15 July, 2005, as the first law pertaining to the treatment and social reintegration of offenders with mental illness in Japan. The purpose of the MTSA is to promote the social rehabilitation of people who have committed serious criminal offenses due to mental disorders. To achieve this goal, subjects are provided with appropriate medical care and continuous supervision to improve their psychiatric symptoms and prevent their recidivism. The framework of the MTSA is shown in Figure 1, and details have been reported previously [1].Figure 1

Bottom Line: We also categorized 30 questions of the DAI-30 into three subscales: "awareness of the need for medication", "awareness of the effects of psychiatric drugs", and "impression of medication", and examined factors affecting improvement in medication adherence.The total DAI-30 score significantly increased after completion of the MDP (P = 0.002).Our study suggests that the MDP has a possibility of improving medication adherence, and this program might have multidirectional and stimulatory effects on each factor related to the improvement of medication adherence.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, National Hospital Organization, Komoro Kogen Hospital, 4598 Kou, Komoro, Nagano 384-8540 Japan ; Department of Psychiatry, Shinshu University School of Medicine, Nagano, Japan.

ABSTRACT

Background: When treating mentally ill criminal offenders, improving medication adherence is essential to achieving goals, such as long-term stabilization of symptoms and the prevention of recidivism. Most subjects who are treated under the Medical Treatment and Supervision Act have schizophrenia, which is considered a particularly difficult disorder for which to improve medication adherence. For such patients, we developed a Medication Discontinuation Program (MDP) that aims to improve medication adherence by discontinuing antipsychotic drugs and monitoring changes in psychiatric symptoms. We examined whether there was any utility for the MDP on a trial basis as well as whether it would be worthwhile to introduce the MDP to psychiatric programs.

Methods: We conducted the MDP with an intervention group (n = 7) and compared Drug Attitude Inventory-30 (DAI-30) scores before and after implementation of the MDP. We also categorized 30 questions of the DAI-30 into three subscales: "awareness of the need for medication", "awareness of the effects of psychiatric drugs", and "impression of medication", and examined factors affecting improvement in medication adherence.

Results: The total DAI-30 score significantly increased after completion of the MDP (P = 0.002). Significant elevations after completion of the MDP were also observed in the scores for three subscales of the DAI-30.

Conclusions: Our study suggests that the MDP has a possibility of improving medication adherence, and this program might have multidirectional and stimulatory effects on each factor related to the improvement of medication adherence.

No MeSH data available.


Related in: MedlinePlus