title: Best practices: A systematic approach to the management of patients who refuse medications in an assertive community treatment team setting.
abstract: A significant proportion of patients of assertive community treatment (ACT) teams will adamantly refuse medication. Whether the team should continue to encourage medication or put a hold on advocating for medication is a clinical and ethical dilemma. On the basis of their clinical experiences, the authors propose best-practices criteria that ACT teams can consider in deciding whether medications may be temporarily discontinued when a patient refuses them. The authors suggest that in some circumstances stopping medications in such a case may help in the development or repair of a therapeutic alliance over the long term.
authors.affiliation: Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Tam
authors.forename: Samuel
authors.initials: S
authors.lastname: Law
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001364:Awareness; D003068:Coercion; D003156:Community Mental Health Services / Q000941:ethics; D003299:Cooperative Behavior; D003617:Dangerous Behavior; D019317:Evidence-Based Medicine / Q000941:ethics; D006801:Humans; D007400:Interprofessional Relations; D016743:Mental Competency; D010817:Physician-Patient Relations / Q000941:ethics; D011379:Prognosis; D012308:Risk Management / Q000941:ethics; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D016312:Treatment Refusal / Q000941:ethics / Q000523:psychology*; D014481:United States
chemical_list: D014150:Antipsychotic Agents