Medication adherence in crisis?
OBJECTIVE
We examined rates of medication non-adherence in 172 referrals to a crisis resolution home treatment service; we then explored any association between pattern of adherence and the treatment interventions recommended.


RESULTS
Thirty percent of crisis referrals (95% confidence intervals (CI) 24%, 38%) reported sub-optimal medication adherence in the preceding month. These individuals were significantly more likely to have a dual diagnosis (odds ratio 2.9, 95% CI 1.4, 5.9) and assessment was significantly more likely to be followed by admission (odds ratio 2.5; 95% CI 1.0, 6.2); non-adherence remained a significant predictor of admission when the odds were adjusted for confounders (odds ratio 1.18; 95% CI 1.0, 1.3).


CONCLUSIONS
Clinicians need to proactively identify and manage non-adherence as it is a potentially preventable trigger of relapse often present for months rather than days prior to the index crisis referral. Non-adherence is a meaningful target for improving clinical and cost-effectiveness of general adult mental health services.
Sreenath
San
S
Northumberland Tyne and Wear NHS Trust, Newcastle upon Tyne, UK.
Reddy
Shallini
S
Tacchi
Mary-Jane
MJ
Scott
Jan
J
D000328:Adult; D016009:Chi-Square Distribution; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D016001:Confidence Intervals; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D016017:Odds Ratio; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D016903:Drug Monitoring