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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

Structure of treatment provided under the Medical Treatment and Supervision Act (MTSA).
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Fig2: Structure of treatment provided under the Medical Treatment and Supervision Act (MTSA).

Mentions: Psychiatric treatment provided under the MTSA aims to achieve the goals of the MTSA by (1) building a treatment alliance between a person who is subject to the MTSA and a multidisciplinary team consisting of a psychiatrist, psychologist, nurse, occupational therapist, and psychiatric social worker; (2) helping the patient recognize the presence of a mental disorder and take responsibility for crimes caused by the illness; and (3) deepening insight and introspection into the disease (Figure 2).Figure 2


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)

Structure of treatment provided under 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

Fig2: Structure of treatment provided under the Medical Treatment and Supervision Act (MTSA).
Mentions: Psychiatric treatment provided under the MTSA aims to achieve the goals of the MTSA by (1) building a treatment alliance between a person who is subject to the MTSA and a multidisciplinary team consisting of a psychiatrist, psychologist, nurse, occupational therapist, and psychiatric social worker; (2) helping the patient recognize the presence of a mental disorder and take responsibility for crimes caused by the illness; and (3) deepening insight and introspection into the disease (Figure 2).Figure 2

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