title: Management of Older Inpatients Who Refuse Nonpsychiatric Medication Within Birmingham and Solihull Mental Health NHS Foundation Trust: Audit.
abstract: The effects of poor medication compliance are well documented and include increased morbidity, early mortality, and financial costs to the society. According to national guidelines, when a competent patient refuses medication, the doctor on duty has a responsibility to ensure the patient understands their proposed course of action. The aims of this audit were to evaluate whether this consultation was taking place within older in-patient units across Birmingham and Solihull Mental Health NHS Foundation Trust when patients refuse nonpsychiatric medicines. Poor compliance was defined as more than five refusals of a nonpsychiatric medication over a 4-week period. A discussion with the duty doctor occurred in 75% of cases (27/36), which resulted in a change in prescription or compliance in 59% (16/27 patients). After patient refusal of medication, a consultation with the duty doctor is likely to improve compliance and uncover salient issues particularly in regards to capacity and drug suitability.
authors.affiliation: Imperial College London, School of Medicine, London; and Heart of England NHS Foundation Trusts, Heartlands Hospital, Birmingham, United Kingdom.
authors.forename: Eno
authors.initials: E
authors.lastname: Umotong
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D054869:Clinical Audit / Q000379:methods*; D019468:Disease Management; D005260:Female; D005582:Foundations; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D008603:Mental Health; D016312:Treatment Refusal / Q000523:psychology*; D006113:United Kingdom / Q000453:epidemiology