Medication acceptance and refusal: a case study analysis of early neuroleptic medication adherence

Poster A95, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Matthew Isaac Peters1, Manuela Ferrari2, Katherine Steger2, Ashok Malla1,2, Jai Shah1,2, Srividya Iyer1,2; 1Department of Psychiatry, McGill University, Montreal, Canada, 2Douglas Mental Health University Institute, Montreal, Canada

Antipsychotic medication adherence is estimated to be below 50% during the first year of treatment at first-episode psychosis clinics . Treatment alliance, family and social support, symptoms resolution, and side-effects are factors which quantitative studies have identified as contributing to medication adherence. Qualitative studies have explored the experience of people taking antipsychotics. Several questions remain over people’s initial decision to accept or refuse medication and their initial experience of taking medication. To address this gap, we used case studies to explore people’s decision to accept or refuse medication and their associated experiences. Twenty-two in-depth interviews were conducted with people prescribed neuroleptics for a diagnosis of affective or non-affective psychosis, and five representative interviews were chosen for further analysis. Family impressions of mental illness and medication strongly affected initial choices around medications. People from cultural backgrounds with explanatory frameworks other than the Western model of mental health often refused medication when it was first offered. For those who accepted medication, family support was important to continuing to take medication, more so than the support of partners or friends. People experiencing side-effects, which affected their health, or social and professional lives, were more likely to stop taking medication. People were more likely to continue medication if symptoms or sleep were improved by medication. People appreciated doctors who were perceived to be responding to their concerns. Finally, clinicians should be attentive to concerns that people have about medication, whether due to cultural differences, side-effects, or interruption of their social and professional lives.

Topic Area: First Episode Psychosis

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