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Medication refusal among patients treated in a community mental health rehabilitation service

Published online by Cambridge University Press:  02 January 2018

Rob Macpherson ,
Minh Alexander  and
W. Jerrom
Rob Macpherson*
Affiliation:
Wotton Lawn, Horton Road, Gloucester GL1 3PX
Minh Alexander
Affiliation:
Royal United Hospital
W. Jerrom
Affiliation:
United Bristol Healthcare Trust, Barrow Hospital, Bristol
*
∗Correspondence
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Abstract

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Aims and method

This study aimed to examine medication refusal and its associated variables in a representative sample of patients on the Gloucester rehabilitation service case register. One hundred and seventy-four of 199 patients on the Gloucester rehabilitation register were surveyed. Insight cognitive function, knowledge of treatment, psychopathology and patient satisfaction were independently rated.

Results

Thirty-five per cent of patients had refused treatment in the past month. Negative attitudes to treatment and historical indices of non-compliance were associated, identifying a consistent core of patients at continuing risk of refusal. However of refusers, 84% were persuaded within one month to take treatment, mostly by their community keyworker. Treatment refusal was associated with diagnosis of affective disorder, higher Brief Psychiatric Rating Scale score and failure to use a dosett dispenser, but not with insight cognitive function, satisfaction with treatment, knowledge of treatment, a range of illness and demographic factors or any particular treatment type.

Clinical implications

Drug refusal was evidently mostly managed by community keyworkers, and without recourse to the Mental Health Act. Simple techniques such as the use of dosett dispenser may be valuable. Problems of communicating with the severely mentally ill about their long-term treatment were discussed.

Type
Original Papers
Information
Psychiatric Bulletin , Volume 22 , Issue 12 , December 1998 , pp. 744 - 748
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1998 The Royal College of Psychiatrists

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