- Upload an essay in 500 words or less that focuses on one nursing challenge presented by individuals suffering from mental illness and/or mental retardation and a realistic plan to improve the health or lives of these individuals.
Nursing Challenge: Addressing Medication Non-Adherence in Patients with Severe Mental Illness
One of the most significant challenges in psychiatric nursing is medication non-adherence among individuals with severe mental illness (SMI), such as schizophrenia, bipolar disorder, and major depressive disorder. Studies indicate that nearly 50% of individuals with SMI do not adhere to their prescribed medication regimen, leading to worsening symptoms, increased hospitalizations, and reduced quality of life (Velligan et al., 2017). The reasons for non-adherence are multifaceted, including lack of insight into their illness (anosognosia), fear of side effects, stigma, and financial constraints. Addressing this issue requires a comprehensive, patient-centered approach that involves education, support systems, and innovative care strategies.
A Realistic Plan for Improvement
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Enhanced Patient Education and Shared Decision-Making
Nurses play a crucial role in providing psychoeducation to patients and their families. Educating patients about their condition, the importance of medication adherence, and potential side effects fosters informed decision-making. Shared decision-making, where patients are actively involved in treatment choices, increases their engagement and likelihood of adherence (Patel et al., 2021). -
Long-Acting Injectable (LAI) Medications
For individuals struggling with daily oral medication adherence, long-acting injectable antipsychotics (LAIs) offer a practical alternative. Administered every two to four weeks, LAIs ensure consistent therapeutic levels, reducing relapse rates and hospitalizations (Correll et al., 2018). Nurses should advocate for LAIs when appropriate and educate patients on their benefits. -
Utilization of Digital Health Interventions
Mobile health apps, automated text reminders, and smart pill dispensers can help track medication adherence. Telehealth services provide remote monitoring and allow nurses to conduct virtual check-ins, reinforcing medication adherence while improving accessibility for those facing transportation barriers. -
Addressing Stigma and Mental Health Support Systems
Many patients with SMI avoid medication due to societal stigma or internalized beliefs about psychiatric treatment. Implementing community-based mental health programs that offer peer support, counseling, and social integration can improve adherence rates. Encouraging family involvement through support groups can also reinforce adherence and help address misconceptions. -
Financial and Policy Advocacy
Cost is a major barrier to medication adherence. Nurses can play a key role in advocating for expanded insurance coverage, patient assistance programs, and access to affordable medications. Partnering with social workers to connect patients with financial aid resources can alleviate some of these barriers.
Conclusion
Medication non-adherence remains a critical challenge in psychiatric nursing, contributing to poor outcomes for individuals with SMI. A multifaceted approach incorporating patient education, alternative medication delivery methods, digital health interventions, stigma reduction, and financial support can significantly improve adherence and overall well-being. Nurses are in a unique position to implement these strategies, ultimately enhancing the quality of life for individuals with mental illness.
References
- Correll, C. U., Rubio, J. M., & Kane, J. M. (2018). What is the risk-benefit ratio of long-acting injectable antipsychotics? Journal of Clinical Psychiatry, 79(5), 1-12.
- Patel, M. X., de Zoysa, N., Bernadt, M., & David, A. S. (2021). A comparison of adherence therapy and health education for people with schizophrenia. Journal of Psychiatric Research, 137, 242-249.
- Velligan, D. I., Weiden, P. J., Sajatovic, M., Scott, J., Carpenter, D., Ross, R., & Docherty, J. (2017). The expert consensus guideline series: Adherence problems in patients with serious and persistent mental illness. Journal of Clinical Psychiatry, 78(3), 1-48.