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Non-compliance and related phenomena

Published online by Cambridge University Press:  13 June 2014

Brian O'Shea*
Affiliation:
Newcastle Hospital, Greystones, Co. Wicklow, University College Dublin, Dublin, Ireland

Abstract

Objective: Review of literature on non-compliance with medication in psychiatric patients.

Method: Computer and manual search of English language literature on non-compliance with drugs, psychiatric disorder, and phenomena which may be related, such as readmission and discharge against medical advice.

Results: The literature is discussed and a tentative checklist of risk factors for non-compliance is offered, as is advice on ways in which the problem may be minimised. It is noted that there is an emphasis on major mental disorders in the published literature.

Conclusion: There is no stereotypical defaulter. A high index of suspicion is essential. As far as possible, the patient should be educated to share in the responsibility for treatment, and concerned relatives and others can often play a pivotal role. More research is required on compliance problems in the minor psychiatric disorders. Close liaison with the general practitioner is vital.

Type
Review
Copyright
Copyright © Cambridge University Press 1995

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References

1.Lamb, HR. Lessons learned from de-institutionalisation in the US. Br J Psychiatry 1993; 162: 587–92.CrossRefGoogle Scholar
2.Fiedman, Ivon Mering, OHinko, EN. Intermittent patienthood. Arch Gen Psychiatry 1966; 14: 386–92.CrossRefGoogle Scholar
3.Bluglass, R. New powers of supervised discharge of mentally ill people. BMJ 1993; 307: 1160.CrossRefGoogle ScholarPubMed
3a.Harrison, GBartlett, P. Supervision registers for mentally ill people. BMJ 1994; 309: 551–2.CrossRefGoogle ScholarPubMed
4.Post, RMLeverich, GSAltschuler, LMikalauskas, K. Lithium-discontinuation-induced refractoriness: preliminary observations. Am J Psychiatry 1992; 149: 1727–9.Google ScholarPubMed
5.Muller-Oerlinghausen, BMuser-Causemann, BVolk, J. Suicides and parasuicides in a high-risk group on and off lithium long-term medication. J Affect Disord 1992; 25:261–70.CrossRefGoogle Scholar
6.Isometsa, EHenriksson, MLonnqvist, J. Completed suicide & recent lithium treatment. J Affect Disord 1992; 26: 101–4.CrossRefGoogle ScholarPubMed
7.Madden, E. Refusal of consent to life-saving treatment. Ir Med Times 1994; 28(17): 23.Google Scholar
8.Blackwell, B. Treatment adherence. Br J Psychiatry 1976; 129: 513–31.CrossRefGoogle ScholarPubMed
9.Blackwell, B. Compliance – measurement and intervention. Curr Opin Psychiatry 1989; 2: 787–9.CrossRefGoogle Scholar
10.Wilson, JDEnoch, MD. Estimation of drug rejection by schizophrenic inpatients, with analysis of clinical factors. Br J Psychiatry 1967; 113: 209–11.CrossRefGoogle ScholarPubMed
10a.Wright, EC. A lesson in non-compliance. Lancet 1994; 343: 1305.CrossRefGoogle ScholarPubMed
10b.Greenberg, RN. Overview of patient compliance with medication dosing: a literature review. Clin Therapeut 1984; 6: 592–9.Google ScholarPubMed
10c.Haynes, RBWang, EDa Mota Gomes, M. A critical review of interventions to improve compliance with prescribed medications. Patient Educat Counselling 1987; 10: 155–66.CrossRefGoogle Scholar
11.Goad, JDEzell, JR. Drug-use evaluation programs for psychotropic medications. Am J Hosp Pharm 1990; 47: 132–6.Google ScholarPubMed
12.Van Putten, T. Noncompliance: problems and solutions. Paper read at symposium, Management of Schizophrenia Toronto, May 1982.Google Scholar
13.Kelly, GRScott, JE. Medication compliance and health education among outpatients with chronic mental disorders. Med Care 1990; 28: 1181–97.CrossRefGoogle ScholarPubMed
14.Appelbaum, PSRoth, LH. Patients who refuse treatment in medical hospitals. JAMA 1983; 250: 1296–301.CrossRefGoogle ScholarPubMed
15.Hoge, SKAppelbaum, PSLawlor, TBeck, JLitman, RGreer, AGutheil, TGKaplan, E. A prospective multicenter study of patients' refusal of antipsychotic medication. Arch Gen Psychiatry 1990; 47: 949–56.CrossRefGoogle ScholarPubMed
16.Van Putten, TCrumpton, EYale, C. Drug refusal in schizophrenia and the wish to be crazy. Arch Gen Psychiatry 1976; 33: 1443–6.CrossRefGoogle ScholarPubMed
17.Buchanan, A. A two-year prospective study of treatment compliance in patients with schizophrenia. Psychol Med 1992; 22: 787–97.CrossRefGoogle ScholarPubMed
18.Marder, SRMebane, AChien, CWinslade, WJSwann, EVan Putten, T. A comparison of patients who refuse and consent to neuroleptic treatment. Am J Psychiatry 1983; 140: 470–2.Google ScholarPubMed
19.Marder, SRSwann, EWinslade, WJVan Putten, TChien, CWilkins, JN. A study of medication refusal by involuntary psychiatric patients. Hosp Commun Psychiatry 1984; 35: 724–6.Google ScholarPubMed
20.Zito, JMRoutt, WWMitchell, JERoerig, JL. Clinical characteristics of hospitalised psychotic patients who refuse antipsychotic drug therapy. Am J Psychiatry 1985; 142:822–6.Google ScholarPubMed
21.Casper, ESPastva, G. Admission histories patterns, and subgroups of the heavy users of a state psychiatric hospital. Psychiat Quart 1990; 61: 121–34.CrossRefGoogle ScholarPubMed
22.Pristach, CASmith, CM. Medication compliance and substance abuse among schizophrenic patients. Hosp Commun Psychiatry 1990; 41: 1345–8.Google ScholarPubMed
22a.Martinez-Arevalo, MWCalcedo-Ordonez, AVaro-Prieto, JR. Cannabis consumption as a prognostic factor in schizophrenia. Br J Psychiatry 1994; 164: 679–81.CrossRefGoogle ScholarPubMed
23.Curson, DABarnes, TREBamber, RWPlatt, SDHirsch, SRDuffy, JC. Longterm depot maintenance of chronic schizophrenic out-patients: the seven year follow-up of the Medical Research Council fluphenazine/placebo trial. II. The incidence of compliance problems side-effects, neurotic symptoms and depression. Br J Psychiatry 1985; 146: 469–74.Google ScholarPubMed
23a.Guscott, RGrof, P. The clinical meaning of refractory depression: a review for the clinician. Am J Psychiatry 1991; 148: 695704.Google ScholarPubMed
24.Aagaard, JVestergaard, P. Predictors of outcome in prophylactic lithium treatment: a 2-year prospective study. J Affect Disord 1990; 18: 259–66.CrossRefGoogle ScholarPubMed
25.Green, JH. Frequent rehospitalisation and noncompliance with treatment. Hosp Commun Psychiatry 1988; 39: 963–6.Google Scholar
26.Leverich, GSPost, RMRosoff, AS. Factors associated with relapse during maintenance treatment of affective disorders. Internat Clin Psychopharmacol 1990; 5: 135–56.CrossRefGoogle ScholarPubMed
27.Goodpastor, WASHare, BK. Factors associated with multiple readmissions to an urban psychiatric hospital. Hosp Commun Psychiatry 1991; 42: 85–7.Google Scholar
28.Raskin, MDyson, WL. Treatment problems leading to readmissions of schizophrenic patients. Arch Gen Psychiatry 1968; 19: 356–60.CrossRefGoogle ScholarPubMed
29.Smith, LD. Medication refusal and the rehospitalised mentally ill inmate. Hosp Commun Psychiatry 1989; 40: 491–6.Google Scholar
30.Rodenhauser, PSchwenkner, CEKhamis, HJ. Factors related to drug treatment refusal in a forensic hospital. Hosp Comcun Psychiatry 1987; 38: 631–7.Google Scholar
31.Rodenhauser, P. Treatment refusal in a forensic hospital: ill-use of the lasting right. Bull Am Acad Psychiatry Law 1984; 12: 5963.Google Scholar
32.Hassenfeld, INGrumet, B. A study of the right to refuse treatment. Bull Am Acad Psychiatry Law lgB4; 12: 6574.Google Scholar
33.Glick, IDHargreaves, WA. Psychiatric hospital treatment for the 1980s: A controlled study of short vs. long hospitalisation. Lexington, MA: Lexington Books, 1979.Google Scholar
34.Ellison, JMAdler, DA. Psychopharmacologic approaches to borderline syndromes. Compr Psychiatry 1984; 25: 255–62.CrossRefGoogle ScholarPubMed
35.Havens, LL. Some difficulties in giving schizophrenic and borderline patients medication. Psychiatry 1968; 31: 4450.CrossRefGoogle ScholarPubMed
36.Bauman, LNieporent, HJSterling, R. Psychiatric outpatient department participation as a function of day-treatment centre behaviour. Internat J Partial Hospitalisation 1987;4:3748.Google Scholar
37.Labreche, GTurner, RJZabo, LJ. Social class and participation in outpatient care by schizophrenics. Commun Mental Health J 1969; 5: 394402.CrossRefGoogle ScholarPubMed
38.Van Putten, T. Why do schizophrenic patients refuse to take their drugs? Arch Gen Psychiatry 1974; 31: 6772.CrossRefGoogle ScholarPubMed
39.Glllum, RFBarsky, AJ. Diagnosis and management of patient noncompliance. JAMA 1974; 228: 1563–7.CrossRefGoogle Scholar
39a.Jamison, KRGerner, RHGoodwin, FK. Patient and physician attitudes toward lithium: relationship to compliance. Arch Gen Psychiatry 1979; 3C: 866–9.CrossRefGoogle Scholar
40.Amarasingham, LR. Social and cultural perspectives on medication refusal. Am J Psychiatry 1980; 137:353–8.Google ScholarPubMed
40a.Babiker, IE. Noncompliance in schizophrenia. Psychiatric Developments 1986; 4: 329–37.Google ScholarPubMed
41.Royal College of Psychiatrists. Research study conducted for the ‘Defeat of Depression’ campaign. London: Royal College of Psychiatrists 1992.Google Scholar
41a.Jadhav, SLittlewood, R. Defeat Depression Campaign. Attitudes towards depression: some medical anthropological queries. Psychiat Bull 1994; 18: 572–3.CrossRefGoogle Scholar
41b.Krulee, DAHales, RE. Compliance with psychiatry referrals from a general hospital outpatient clinic. Gen Hosp Psychiatry 1988; 10: 33g45.CrossRefGoogle Scholar
42.Davy, D. Dawn Davy's story. Daily Telegraph 1993; August 10: 13.Google Scholar
43.Amdisen, A. Drug-produced obesity: experiences with chlorpromazine perphenazine and clopenthixol. Danish Med Bull 1964; 11: 182–9.Google ScholarPubMed
44.Appelbaum, PSGutheil, TG. “Rotting with their rights on”: constitutional theory and clinical reality in drug refusal by psychiatric patients. Bull Am Acad Psychiatry Law 1979; 7: 308–27.Google ScholarPubMed
45.O'Shea, BMcGemlis, A. ECT: lay attitudes and experiences - a pilot study. Ir Med J 1983;76:40–3.Google ScholarPubMed
46.Jankowski, CBDrum, DE. Diagnostic correlates of discharge against medical advice. Arch Gen Psychiatry 1977; 34: 153–5.CrossRefGoogle ScholarPubMed
47.Chandrasena, R. Premature discharges: a comparative study. Can J Psychiatry 1987;32:259–63.CrossRefGoogle ScholarPubMed
48.Chandrasena, RMiller, WC. Discharges AMA and AWOL: a new “revolving door syndrome”. Psychiat J Univ Ottawa 1988; 13: 154–7.Google Scholar
49.Pablo, RYKadlec, KEArboleda-Florez, J. The readmission of psychotic patients to a general hospital psychiatry unit. Gen Hosp Psychiatry 1986; 8: 190–7.CrossRefGoogle ScholarPubMed
50.Holden, PVogtsberger, KNMohl, PCFuller, DS. Patients who leave the hospital against medical advice: the role of the psychiatric consultant. Psychosom 1989; 30: 396404.CrossRefGoogle ScholarPubMed
51.Treffert, DA. Marijuana use in schizophrenia: a clear hazard. Am J Psychiatry 1978; 135: 1213–5.Google ScholarPubMed
52.Tsuang, MTSimpson, JCKronfol, A. Subtypes of drug abuse with psychosis. Arch Gen Psychiatry 1982; 39: 141–7.CrossRefGoogle ScholarPubMed
53.Vardy, MMKay, SR. LSD psychosis or LSD-induced schizophrenia? Arch Gen Psychiatry 1983;40:877–83.CrossRefGoogle ScholarPubMed
54.Knudson, PVilmar, T. Cannabis and neuroleptic agents in schizophrenia. Acta Psychiatr Scand 1984; 69: 162–74.CrossRefGoogle Scholar
55.Bowers, MBMazure, CMNelson, JCJatlow, PI. Psychotogenic drug use and neuroleptic response. Schizophren Bull 1990; 16: 81–5.CrossRefGoogle ScholarPubMed
56.Miller, GHWilier, B. Predictors of return to a psychiatric hospital. J Consult Clin Psychology 1976; 44: 898900.CrossRefGoogle ScholarPubMed
57.Fontana, AFDowds, BN. Assessing treatment outcome. II: The prediction of rehospitalisation. J Nerv Kent Dis 1975; 161: 231–8.CrossRefGoogle Scholar
57a.Mortensen, PBEaton, WW. Predictors for re-admission risk in schizophrenia. Psychol Med 1994; 24: 223–32.CrossRefGoogle Scholar
58.Kiloh, LGAndrews, GNeilson, M. The long-term outcome of depressive illness. Br J Psychiatry 1988; 153: 752–7.CrossRefGoogle ScholarPubMed
59.Rosenblatt, AMayer, JE. The recidivism of mental patients: a review of past studies. Am J Orthopsychiatry 1974; 44: 697706.CrossRefGoogle ScholarPubMed
60.De Francisco, DAnderson, DPantano, RKline, F. The relationship between length of hospital stay and rapid-readmission|rates. Hosp Comm Psychiatry 31; 1967.Google Scholar
61.Boydell, KMMalcolmson, SASikerbol, K. Early|rehospitalisation. Can J Psychiatry 1991; 36: 7435.Google ScholarPubMed
62.Caton, CLMKoh, SPFleiss, JLBarrow, SGoldstein, JM. Rehospitalisation in chronic schizophrenia. J Nerv Ment Dis 1985; 173: 139–48.CrossRefGoogle Scholar
63.Goldberg, SCSchooler, NRHogarty, GERoper, M. Prediction of relapse in schizophrenic outpatients treated by drug and sociotherapy. Arch Gen Psychiatry 1977; 34: 171–84.CrossRefGoogle ScholarPubMed
64.Tessler, RCDennis, DL. A synthesis of NIMH-funded research concerning persons who are homeless and mentally ill. Rockville, (MD): National Institute of Mental Health 1989.Google Scholar
65.Drake, REWallach, MAHoffman, JS. Housing instability and homelessness among aftercare patients of an urban state hospital. Hosp Comm Psychiatry 1989; 40:4651.Google ScholarPubMed
66.Drake, REWallach, MATeague, GBFreeman, DHPaskus, TSClark, TA. Housing instability and homelessness among rural schizophrenic patients. Am J Psychiatry 1991; 148:330–6.Google ScholarPubMed
67.Polk-Walker, GCChan, WMeltzer, AAGoldapp, GWilliams, B. Psychiatric Recidivism prediction factors. West J Nurs Res 1993; 15: 163–76.CrossRefGoogle ScholarPubMed
68.Hanson, GBablngian, H. Reasons for hospitalisation from a psychiatric emergency service. Psychiat Quart 1974; 48: 336–51.CrossRefGoogle ScholarPubMed
69.Horowitz, A. The pathways into psychiatric treatment: Some differences between men and women. J Health Soc Behav 1977; 18: 169–78.CrossRefGoogle Scholar
70.Richart, RMillner, L. Factors influencing admission to a community mental health centre. Commun Ment Health J 1968; 4: 25–7.CrossRefGoogle Scholar
71.Sims, A. Factors predictive of outcome in neurosis. Br J Psychiatry 1975; 127: 5462.CrossRefGoogle ScholarPubMed
72.O'Shea, BFalvey, J. A retrospective study of charts according to size: implications for management and prevention? Psychiatr Bull 1991; 15: 262–4.CrossRefGoogle Scholar
73.Davis, MS. Variations in patients' compliance with doctors' orders: analysis of congruence between survey responses and results of empirical investigations. J Med Educ 1966; 41: 1037–48.Google ScholarPubMed
74.Carson, HSRoth, HP. Patients' cooperation with a medical regimen: difficulties in identifying the non-cooperator. JAMA 1968; 203: 922–6.CrossRefGoogle Scholar
75.Moulding, TOnstad, GDSbarbaro, JA. Supervision of outpatient drug therapy with the medication monitor. Ann Intern Med 1970; 73: 559–64.CrossRefGoogle ScholarPubMed
75a.Wright, EC. Non-compliance: or how many aunts has Matilda? Lancet 1993; 342:909–13.CrossRefGoogle ScholarPubMed
76.Stimson, GV. Obeying doctor's orders: a view from the other side. Soc Sci Med 1974;8:97104.CrossRefGoogle Scholar
77.Myers, EDCalvert, EJ. Information, compliance and side-effects: a study of patients on anti-depressant medication. Br J Clin Pharmacol 1984; 17: 21–5.CrossRefGoogle Scholar
78.McMahon, TClark, CMBailie, GR. Who provides patients with drug information? BMJ 1987; 294: 355–6.CrossRefGoogle ScholarPubMed
79.Anonymous, . Interview with Barry, Blackwell. Improving medication compliance in schizophrenic patients. Current Approaches to Psychoses 1994; 3: 67.Google Scholar
79a.Walker, R. Which medication compliance device? Pharmaceut J 1992; 249: 605–7.Google Scholar
79bXiang, MRan M, Li S. A controlled evaluation of psychoeducational family intervention in a rural Chinese community. Br J Psychiatry 1994; 165: 544–8.CrossRefGoogle Scholar
80.Matthews, DHingson, R. Improving patient compliance. A guide for physicians. Med Clin North America 1977; 61: 879–89.CrossRefGoogle ScholarPubMed
81.Jonsson, BBebbington, PE. What price depression? The cost of depression and the cost-effectiveness of pharmacological treatment. Br J Psychiatry 1994; 164: 665–73.CrossRefGoogle ScholarPubMed
82.Stokes, PE. Fluoxetine: a five-year review. Clin Therapeut 1993; 15: 216–43.Google ScholarPubMed
83.Beasley, CMDornseif, BEBosomworth, JCSayler, MERampey, AHHelligenstein, JHThompson, VLMurphy, DJMasica, DN. Fluoxetine and suicide: a metaanalysis of controlled trials of treatment for depression. BMJ 1991; 303: 685–92.CrossRefGoogle ScholarPubMed
84.Maddox, JCLevi, MThompson, C. The compliance with antidepressants in general practice. J Psychopharmacol 1994; 8: 4853.CrossRefGoogle ScholarPubMed
85.Guscott, RTaylor, L. Lithium prophylaxis in recurrent affective illness: efficacy, effectiveness and efficiency. Br J Psychiatry 1904; 164: 741–6.CrossRefGoogle Scholar
86.Curran, SMPullen, IM. Audit of a psychiatric liaison service: the value of general practice case notes. Psychiatric Bull 1990; 14: 727–9.CrossRefGoogle Scholar
87.Gask, L. What happens when psychiatric out-patients are seen only once? Br J Psychiatry 1986; 148: 6636.CrossRefGoogle Scholar
88.Blacker, CVRClare, AW. The prevalence and treatment of depression in general practice. Psychopharmacology 1988; 95: S14S17.CrossRefGoogle ScholarPubMed