The impact of informing psychiatric patients about their medication: a systematic review.
OBJECTIVE
This literature study explores the impact of educational interventions about medicines for psychiatric patients on adherence, knowledge and economic, clinical and humanistic outcomes.


METHODS
A systematic review of eight electronic databases was carried out. Reference lists of primary studies were searched. Studies measuring the impact of medication information for adult psychiatric patients in an individual way on adherence, knowledge, economic, clinical and humanistic outcomes were included. Data analysis and assessment of methodological quality were executed according to the Cochrane Collaboration guidelines. A meta-analysis of primary studies was not suitable due to the heterogeneity of the primary studies.


RESULTS
Literature search generated 17 studies. Thirteen studies measured adherence, seven of which reported an increase. Generally, adherence was 11-30% higher in the intervention groups than in the control group. A combination of oral and written information seemed to have an added value as compared with supplying exclusively oral or written information. The provision of easily readable written information improved adherence by 11%. Seven of the eight studies measuring knowledge reported an overall improvement. Knowledge was increased with 14-28% in interventions groups in comparison with control group. One study reported an increased satisfaction. No significant differences were seen for frequency of side-effects, relapse or admission rates, symptoms and quality of life. Not one of the 17 studies explored the economic impact of the educational intervention. The methodological quality of the included studies was variable. Individual studies suffered from a variety of biases and other methodological limitations.


CONCLUSIONS
The included studies suggested a positive impact on adherence and knowledge. As only one study assessed patient's satisfaction, no definitive conclusions can be made. No significant differences were observed for frequency of side-effects, relapse or admission rates, symptoms and quality of life. Studies on the cost-effectiveness of such interventions need to be performed. In general, more well-designed studies with good methodological quality in this research domain are needed.
Desplenter
Franciska A M
FA
Research Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium. Franciska.Desplenter@pharm.kuleuven.be
Simoens
Steven
S
Laekeman
Gert
G
D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D028642:Persons with Psychiatric Disorders; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000592:standards*; D010593:Pharmaceutical Services; D010595:Pharmacists