3.1.2 Telenursing intervention increases psychiatric medication adherence in schizophrenia outpatients (227)
Lora Beebe, Associate Professor, Nursing, University of Tennessee College of Nursing, Knoxville, United States of America Co authors: Kathlene Smith, Carol Crye, Caryn Addonizio, D.J. Strunk, Whitney Martin, & Josh Poche lbeebe1@utk.edu
Abstract:
Background:
Promoting medication adherence is a critical issue in optimizing both physical and mental health in persons with schizophrenia. Average antipsychotic medication adherence is approximately 50%; few studies have examined nonpsychiatric medication adherence in this group. Psychosocial interventions with components of problem solving and motivation have shown promise in improving adherence behaviors.
Aims:
This study examined the effectiveness of Telephone Intervention-Problem Solving (TIPS) in increasing medication adherence for outpatients with schizophrenia. TIPS is a weekly, provider-initiated, proactive telenursing intervention designed to assist persons with schizophrenia respond to a variety of problems in community living, including adherence problems.
Methods:
Experimental with a convenience sample. Randomly assigned experimental participants (n = 13) received TIPS weekly for three months; controls (n = 12) received treatment as usual. Medication adherence was measured by monthly in-home pill counts. Data collection began in June 2006 and was completed in April 2007.
Results:
Average psychiatric medication adherence was 80% for experimental participants (95% Confidence Interval (CI) = 67-88%) and 60.1% (95% CI = 47-78%) for controls. Average adherence for nonpsychiatric medications was 33% for experimentals (95% CI = 20-50%) and 22% for controls (95% CI = 12-39%). Persons receiving TIPS had significantly higher adherence to psychiatric medications throughout the study period (F (1, 20) = 5.47, p = 0.0298).
Discussion:
Knowledge of interventions to promote adherence to psychiatric and nonpsychiatric medications may help practitioners reduce the negative health consequences of nonadherence, with the overall goal of health promotion for persons with schizophrenia. While our findings must be considered preliminary, our prior work demonstrated fewer rehospitalizations in persons receiving TIPS. This study indicates that psychiatric medication adherence may be a possible mechanism of this result.
Conclusions:
Clinicians should consider using TIPS as an adjunct to face-to-face appointments to support adherence in persons with schizophrenia.
Source of Funding: Non UK
Level of funding: 1,000 - 10,000
Biography:
Dr. Beebe is an Associate Professor at the University of Tennessee College of Nursing. She received her PhD from the University of Kentucky in 2000. Dr. Beebe has over 20 years’ experience in the care of persons with schizophrenia. Her clinical experiences include group, individual, family, inpatient and outpatient venues in both rural and urban settings. She has supervised graduate/undergraduate students in research and clinical work with this population. Her research has focused on improving the health of community-dwelling persons with schizophrenia for the past 12 years. She developed the theoretically based Telephone Intervention for Persons with schizophrenia, and empirically validated it in two prior studies with this population. In addition, Dr. Beebe currently has an NIH funded study to examine the effect of a motivational intervention on the exercise behavior of outpatients with schizophrenia. She is a two-time recipient of the Excellence in Research Award from the American Psychiatric Nurses’ Association.