Magazine article Clinical Psychiatry News

Work with Patients Is the Key to Improving Medication Adherence. (Consider Reasons for Noncompliance)

Magazine article Clinical Psychiatry News

Work with Patients Is the Key to Improving Medication Adherence. (Consider Reasons for Noncompliance)

Article excerpt

CHARLOTTESVILLE, VA. -- To some extent, patients and physicians work at cross-purposes when it comes to medications, Dr. Steve Goldfinger said at a meeting on mental health sponsored by the University of Virginia.

Given that, don't be surprised when patients don't take their medicine. "Pills don't work if you don't take them," he said. Often psychiatrists are busy trying to titrate doses of medications to improve symptoms, only to find out from blood analysis that patients aren't taking any of them.

"The core of the matter is that we care about effects and our patients care about side effects," said Dr. Goldfinger of the State University of New York Brooklyn. Psychiatrists only ask about side effects that they care about. They don't ask about sexual side effects, weight gain, or other side effects that are important to patients.

"In fact, medications do not have effects and side effects. They only have effects," he said. Diphenhydramine is the perfect is example. "If you take it because you have a runny nose, the fact that it makes you drowsy is a side effect. If you take it because you can't sleep, the fact that it makes you dry is a side effect," he said.

From the patient's perspective, there is a spectrum of acceptability of medications. Medications that have an immediate desired effect without side effects are medications that patients want to take. Medications that have little perceived effect and few side effects are less likely to be taken by patients. Medications that have delayed or unwanted side effects and that, in the patient's perspective, treat symptoms that patients don't think they have are very unlikely to be taken by patients. …

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