New research conducted by Aston Pharmacy School has highlighted the importance of peer support for individuals with severe mental illness who are taking medication. The study aimed to understand the complexities of medication in severe mental illness and identify potential solutions. It found that without additional support, there is a risk of patients not adhering to their medication regimes.
Severe mental illness encompasses various conditions, including schizophrenia and bipolar disorder, which are typically treated with medications such as antipsychotics and mood stabilizers. However, these medications can have extreme side effects, particularly during the early stages of treatment, which can result in low patient adherence.
The research, led by Dr. Jo Howe and Professor Ian Maidment, explored the role of shared decision-making between patients and clinicians in improving medication management. The study was conducted as part of the MEDIcation optimisATion in severE mental illness (MEDIATE) project, which took place from November 2021 to March 2023.
In addition to reviewing existing literature, the researchers engaged with clinicians and individuals living with severe mental illness from the Birmingham and Solihull Mental Health NHS Foundation Trust to gather insights and guide the study. They discovered that a person-centered approach, coupled with a trusting relationship between the patient and clinician, fosters improved medication decision-making, ensuring that patients receive the appropriate medication at the correct dosage and time.
However, individuals diagnosed with severe mental illness often have infrequent appointments with their psychiatrists, with gaps of several months. During these periods, if a patient experiences a negative reaction to medication, they may seek information from unreliable sources or stop taking the medication altogether, resorting to self-medication.
One of the study’s participants, Max Carlish, who has been living with bipolar disorder for 19 years, emphasized the importance of the relationship between patients and prescribers. He stated that this relationship is often overlooked and under-researched, despite being a significant part of every service user’s life. Carlish advocated for trained and effective peer support to bridge the gaps in medication advice. While peer support is common in mental health, there has been resistance to incorporating support for medication management. However, the study revealed the need for further research on the required training and support for peer support workers in this area.
The researchers emphasized the seriousness of these conditions and the severe consequences that may arise if medication management is not adequate. They found that individuals with severe mental illness often lack sufficient information about their diagnosis and medication, leading them to seek information from online platforms like Reddit, which may or may not provide accurate advice. The implementation of a proper support system and trained peer support could help individuals identify reliable sources of information.
Both patient groups and clinicians participating in the study agreed that properly trained peer support has a significant role to play in medication management. Individuals with personal experiences can share advice that may not be found in information leaflets or considered by those without firsthand experience with the medication. This could include suggestions such as taking medication before bedtime if it causes drowsiness or reassuring individuals that initial side effects may diminish over time.
The researchers also noted the lack of research in minority ethnic communities and the evidence suggesting that members of these communities are more likely to receive coercive medication. Further exploration of this area is crucial. Additionally, there is a scarcity of research written from a patient perspective.
Professor Maidment, who conceived the MEDIATE project and has worked in mental health for over 25 years, emphasized the devastating consequences of untreated mental illness. He highlighted the need for effective innovative approaches and stated that future research will focus on investigating how peer support workers can help individuals living with severe mental illness manage their medication more effectively and improve their quality of life.
1. Source: Coherent Market Insights, Public sources, Desk research
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