The Importance of Medication Adherence in Mental Health Treatment

Sometimes mental health issues become so serious that hospitalization or residential treatment programs may be necessary; talk therapy and medications may form part of this plan of care.

Attributors that affect medication adherence include sociodemographics, psychiatric diagnoses, and malleable risk factors for non-adherence. Through stepwise multiple regression analysis, all these variables were entered simultaneously before being assessed to find the most relevant predictors of medication adherence.

1. Symptom Management

Though mental illness has become less stigmatized over time, poor medication adherence among psychiatric patients remains common and contributes to subpar disease outcomes1.1

As is well-documented, adhering to prescribed medications has numerous symptom management advantages that include reduced relapse risk, improved quality of life, lower mortality rates and fewer hospitalizations.

Medication nonadherence is often caused by factors unique to each patient, and requires multiple strategies in order to effectively address. According to several studies, specific patient characteristics (e.g. insight, attitudes and beliefs about illness, level of support and therapeutic alliance), physician-patient communication and routine follow up are linked with better medication adherence.

As these barriers vary depending on each patient, it is vital that clinicians take time to identify them and create an action plan for overcoming them. Combinatorial interventions have proven more successful than single-step efforts like motivational interviewing alone in doing this work.

2. Reduced Risk of Relapse

Medication is an integral component in treating bipolar disorder or schizophrenia, helping individuals maintain more stable lives through reduced mood swings, hallucinations reduction and calm anxiety levels. Non-adherence with an established treatment plan has been associated with increased relapse rates, higher hospitalization risks and diminished quality of life for many.

According to a survey of patients discharged from an inpatient psychiatric unit, poor medication adherence was the leading factor leading to relapse (50.7%). Other contributing factors were negative attitudes toward medications, desire to “get better”, and pressure from significant others.

However, it should be remembered that adherence isn’t always ideal and may involve isolated or consecutive drug omissions, medication holidays, and compensatory overdosing. Therefore, it can be challenging to establish the threshold level of adherence; nonetheless there are effective strategies available such as motivational interviewing, cognitive-behavioral therapy and telemedicine consultations to promote medication adhesion.

3. Enhanced Quality of Life

Medication can provide significant improvements in quality of life for individuals living with mental illness. Medication can help stabilize moods or suppress hallucinations, enabling patients to engage in more productive activities and socialize more successfully with others. Furthermore, taking medication regularly prevents relapse or worsening of symptoms which could impact personal and professional lives adversely.

Medication non-adherence costs the healthcare system significant sums of money and contributes to poorer health outcomes [38]. Non-adherence also increases patients’ out-of-pocket expenses as they may need extra doctor consultations or hospital stays due to complications from their chronic disease.

As such, it is vitally important to identify and overcome barriers to adherence, such as patient satisfaction with life and the role of significant others in decision-making processes and how effectively they communicate with their doctors. Interventions addressing specific barriers should be tailored accordingly with multiple means of assessment such as self-report scales, pill counts, serum levels or pill opening monitoring systems incorporated to ensure effectiveness4. Replicating interventions regularly with routine follow up are also key in maintaining consistent gains in adherence over time4.

4. Reduced Medications Costs

Medication costs can be one of the costliest components of healthcare, with adherence being linked with lower out-of-pocket medication costs and non-adherence leading to increased healthcare expenses overall; one study on schizophrenia patients found that every time their medications were interrupted it resulted in increased costs by an average of $873 annually.

Medication non-adherence can be caused by multiple factors, including financial and clinical concerns. Many of these can be addressed through education and counseling; providers can help reduce costs by prescribing medications from a formulary or generic pharmacy list, as well as encouraging their patients to use pharmacy price comparison websites.

Recent reviews that assess changes in health care costs and adherence found that even small increases in adherence can significantly lower healthcare spending overall, and are therefore encouraging as they reveal the true extent of potential savings that lie between adherent and nonadherent categories.