Improving Medication Compliance in Mental Health



Improving Medication Compliance in Mental Health

QUESTION
Purpose of the Project Proposal: This will be your initial proposal for the project you will be completing in this class. The purpose of the proposal to is to ensure the student is choosing a project that will enhance their understanding of nursing issues and trends and how this may affect or influence their anticipated career trajectory. This proposal will be an introduction to the ideas you have regarding the project you would like to complete for this course. The project will be executed in the form of a comprehensive literature review.
Guidelines for Completing the Proposal: The proposal will be reviewed and graded by the faculty. After review, the proposal will be granted approval, approval with revisions, or denial and assigned a grade.

The proposal must be written in an APA formatted paper (about 5 pages) and it is suggested you use the following criteria as section headers. A proposal, in essence, in a brief description of the project you wish to undertake.
Improving Medication Compliance in Mental Health

ANSWER
Improving Medication Compliance in Mental Health
Student name
Affiliation institution
Instructor
Date

Project Title: Improving Medication Compliance in Mental Health
Introduction to the project
Medication compliance (also referred to as medication adherence) dramatically impacts the quality and length of long life. It also helps increase health outcomes and is instrumental in overall healthcare costs. Conversely, medication non-adherence contributes to close to 100 – 300 Billion US dollars in avoidable healthcare costs per year and is responsible for 50 per cent of treatment and nursing failures and hundreds of thousands of preventable death per year (US Pharmacist, 2018).
Patients suffering from mental health encounter intense struggles in managing life and their mental condition. Medication and counselling are usually a struggle in managing symptoms while navigating the multifaceted healthcare system. Consequently, according to the Substance Abuse and Mental Health Services Administration (2014), one program considered ideal is modelling integrated treatment that coordinates care in a single setting. It is in this instance that nursing comes into practice. Patients with severe psychiatric conditions like schizophrenia and with paranoid thoughts or severe depression usually have difficulty repelling negative behaviours and beliefs that lead to addiction and substance abuse.
Consequently, grown-ups who experience any form of mental illness for a consecutive year are thrice more likely to abuse or be substance dependent; this is 20 % more than the non-concurrent 6% (SAMHSA, 2014). Therefore, these statistics are fundamental that teaching psychiatric patients about medications is encouraged as part of integrated care. In addition, people experiencing severe symptoms need extensive support services since their medication treatment is longer to achieve better outcomes.
This project will focus on models useful in improving medication compliance in mental health. The models will be investigated through a literature review and analysis done concerning nursing practice.
Applicability to Nursing Practice
The complexity of non-adherence to medication among psychiatric patients is an important clinical issue. According to Phan, (2016) and Steinkamp et al., 2019), some of the factors linked to non-adherence to medication by mental illness patients include stigma, substance abuse disorder, socio-economic status, psychopathology, lack of awareness and care fragmentation, among others. Medication administration is an important nursing responsibility that requires constant and subsequent improvement. This study will explore the role of nurses in ensuring patients comply with medication and investigating new strategies that may be employed to improve medication compliance in people with a mental health conditions. Nurses play a huge role in helping patients manage medication; therefore, nurses must understand patients’ beliefs about the medication they are taking and the prospective side effects (Brown & Gray, 2015). Mental health nurses (MHNs), have the role of providing psychological education to patients to increase understanding of the disease and recognition of medications. As part of improving patient medication compliance, psychiatric nurses ensure that patients undertake cognitive behaviour therapy and employ motivational interviewing to improve patient medication in the healthcare setting. According to Verdoux et al. (2017), failure of patient education on medication and cognitive therapy can lead to medication non-compliance, which can be substituted with long-acting antipsychotic injections. Evidence-based practices require that mental health nurses build an excellent therapeutic interpersonal relationship with psychiatric patients to improve medication adherence. A therapeutic alliance of health professionals involves emotionally connecting with patients, cooperation, and setting common medication goals among professionals and patients (Martin et al., 2000). Listening to and interpreting patients’ needs and concerns is one of the strategies used to build trustworthy relationships with patients. However, this method is not very practical for some schizophrenia patients since they are not hospitalized voluntarily. Therefore their relationship with medical professionals, especially nurses, is not readily established, which makes the implementation of medication adherence promotion strategies difficult for nurses. Positive nursing practices have the possibility of helping patients to change their perceptions towards illness and hence increase and improve medication adherence.
Applicability to Anticipated Career Trajectory
The journey to attaining a Doctoral in Nursing Practice has been a gradual process of getting equipped with the skills and knowledge needed in my career. Mental health has explicitly been my passion and purpose to continue providing my services to ailing people who, in some instances, are cast out by a society that does not understand what they are going through. Having interacted with various mental health groups, I have learned and honed my leadership skills. As a DNP, I desire to design programs that bridge the gap between mental health patients, their families, and medical health professionals. Further, I wish to explore interventions for improving medication adherence among the mental health population and ways in which systems within healthcare would be modernized to ensure medication adherence is manual-based and digitized. Finally, I wish to affiliate myself with formulating scholarly evidence on models of nursing practice that improve on medication adherence but are limited due to community settings, patient’s environment, socio-economic status and specific medications. As a scholar, and an advancing doctor in nursing, the study will offer an opportunity to be a team leader in ways of implementing strategies in medical research and expanding knowledge and finding within the mental health population.
Identification of a Conceptual framework
The Iowa model is most suitable and applicable to the study of medication adherence. The Iowa model translates empirical evidence into practise to improve the quality of care (Titler et al, 2001). It is comprised of 7 stages that denote data collection. First, the data is used to provide evidence on the problem of the study. The model is applicable in helping psychiatric clinicians and other healthcare professionals to apply research findings into nursing practice to improve health outcomes.
The first stage aims to identify a knowledge-based trigger that necessitates a change in evidence-based practice. The second involves team formation; the teams ought to develop, implement and evaluate changes in evidence-based practice. The third involves collection and analyzing of collected research. The forth entails critiquing and synthesizing research evidence. The fifth involves making recommendations upon the made evidence synthesis. The sixth stage involves the implementation of the recommendations. The final stage is evaluation of the feasibility of the changes implemented. The Iowa model provides a framework for undertaking a systematic review.
In this case, improving medication compliance in mental health requires evaluating evidence-based research in strategies applicable to improving medication adherence in mental health. Medication non-adherence among the mental illness population, especially in the United States, requires intense intervention to improve health outcomes within the mental population. A
The systematic study provides a progressive step in formulating effective evidence-based strategies for improving medication compliance in mental health.

Expected Outcomes
Exploring strategies that improve medication adherence in mental health requires also studying the impacts of non-adherence in the healthcare system. The review and study of non-adherence to medication in mental health significantly influence mental health patient outcomes. Further, the finding and knowledge gathered to influence the type of strategies used by psychiatric clinicians and nurses to promote and improve medication adherence by mental illness patients. The study potentially raises positive societal change among the mental patient population, reducing comorbidity, hospitalization, and risk of re-hospitalization due to relapse. Reduction in comorbidities consequently reduces healthcare costs for mental health. The study also raises awareness among the mental healthcare stakeholders, including psychiatry facilities, health legislation bodies, mental health professionals and the affected population. According to Steinkamp et al (2019), improving medication adherence potentially reduces hospitalization among schizophrenia and bipolar disorder patients. The study will facilitate psychiatric medical professionals’ change in mental healthcare practice by enhancing understanding of evidence-based strategies for improving medication adherence among mental health patients. Through this understanding, clinicians have an improved chance to educate specific patients on the best interventions depending on their level of illness. As an academic scholar, the skills I have acquired in research, data collection and analytics will strengthen my ability to access various previous analyses and help me appraise relevant studies.

References
Brown E., Gray R. (2015). Tackling medication non-adherence in severe mental illness: Where
are we going wrong? J. Psychiatr. Ment. Health Nurs. ;22:192–198.
doi: 10.1111/jpm.12186.
Martin D.J., Garske J.P., Davis M.K. (2000). Relation of the therapeutic alliance with outcome
and other variables: A meta-analytic review. J. Consult. Clin. Psychol. ;68:438–450.
doi: 10.1037/0022-006X.68.3.438
Phan, S. V. (2016). Medication adherence in patients with schizophrenia. The International
Journal of Psychiatry in Medicine, 51(2), 211-219. doi:10.1177/0091217416636601
Steinkamp, J. M., Goldblatt, N., Borodovsky, J. T., LaVertu, A., Kronish, I. M., Marsch, L. A.,
& Schuman-Olivier, Z. (2019). Technological interventions for medication adherence in
adult mental health and substance use disorders: A systematic review. Journal of Medical
Internet Research Mental Health, 6(3), e12493. doi:10.2196/12493
Substance Abuse and Mental Health Services Administration. (2014). The NSDUH Report:
Substance Use and Mental Health Estimates from the 2013 National Survey on Drug Use
and Health: Overview of Findings. Center for Behavioral Health Statistics and Quality.
Rockville: SAMHSA.
Verdoux H., Pambrun E., Tournier M., Bezin J., Pariente A. (2017) Risk of discontinuation of
antipsychotic long-acting injections vs. oral antipsychotics in real-life prescribing
practice: A community-based study. Acta Psychiatr. Scand.;135:429–438.
doi: 10.1111/acps.12722.

Improving Medication Compliance in Mental Health


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