The impact of informing psychiatric patients about their medication: a systematic review
- 373 Downloads
This literature study explores the impact of educational interventions about medicines for psychiatric patients on adherence, knowledge and economic, clinical and humanistic outcomes.
A systematic review of eight electronic databases was carried out. Reference lists of primary studies were searched. Studies measuring the impact of medication information for adult psychiatric patients in an individual way on adherence, knowledge, economic, clinical and humanistic outcomes were included. Data analysis and assessment of methodological quality were executed according to the Cochrane Collaboration guidelines. A meta-analysis of primary studies was not suitable due to the heterogeneity of the primary studies.
Literature search generated 17 studies. Thirteen studies measured adherence, seven of which reported an increase. Generally, adherence was 11–30% higher in the intervention groups than in the control group. A combination of oral and written information seemed to have an added value as compared with supplying exclusively oral or written information. The provision of easily readable written information improved adherence by 11%. Seven of the eight studies measuring knowledge reported an overall improvement. Knowledge was increased with 14–28% in interventions groups in comparison with control group. One study reported an increased satisfaction. No significant differences were seen for frequency of side-effects, relapse or admission rates, symptoms and quality of life. Not one of the 17 studies explored the economic impact of the educational intervention. The methodological quality of the included studies was variable. Individual studies suffered from a variety of biases and other methodological limitations.
The included studies suggested a positive impact on adherence and knowledge. As only one study assessed patient’s satisfaction, no definitive conclusions can be made. No significant differences were observed for frequency of side-effects, relapse or admission rates, symptoms and quality of life. Studies on the cost-effectiveness of such interventions need to be performed. In general, more well-designed studies with good methodological quality in this research domain are needed.
KeywordsAdherence Educational intervention Knowledge Medication information Outcomes Psychiatric patients Systematic review
This research was supported by a grant of the Institute for the Promotion of Innovation through Science and Technology in Flanders (IWT-Vlaanderen).
- 1.World Health Organisation, Fact sheet No 265. The World Health Report 2001 on mental and neurological disorders, December 2001. http://www.who.int/mediacentre/factsheets/fs265/en/ (2 September 2004).Google Scholar
- 4.Angunawela II, Mullee MA. Drug information for the mentally ill: a randomized controlled trial. Int J Psych Clin Pract 1998;38:121–7.Google Scholar
- 7.Haynes RB, McDonald H, Garg AX, Montague P. Interventions for helping patients to follow prescriptions for medications. The Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD000011. DOI: 10.1002/14651858.CD000011. This version first published online: 22 April 2002 in Issue 2, 2002.Google Scholar
- 10.Deijen JB, Kornaat H, Cloin PA. The effect of brochures and audiotape on efficacy and tolerability of venlafaxine in depressed outpatients: a single-blind parallel study in general practice. J Clin Psychiatry 2000;2:89–95.Google Scholar
- 11.Fawcett J. Compliance: definitions and key issues. J Clin Psychiatry 1995;56(S1): S4–10.Google Scholar
- 23.Alderson P, Green S, Higgins JPT, editors. Cochrane Reviewers’ Handbook 4.2.2. [updated March 2004]. http://www.cochrane.org/resources/handbook/hbook.htm (accessed 4th November 2004)Google Scholar
- 28.Kleinman I, Schachter D, Jeffries J, Goldhamer P. Effectiveness of two methods for informing schizophrenic patients about neuroleptic medication. Hosp Community Psychiatry 1993;44(12):1189–91.Google Scholar