Advances in Psychiatric Treatment (2007) 13: 347-349. doi: 10.1192/apt.bp.107.003707
© 2007 The Royal College of Psychiatrists
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How can clinicians help patients to take their psychotropic medication?

Invited commentary on... Why don’t patients take their medicine?{dagger}

Robert Chaplin

Robert Chaplin is a consultant in general adult psychiatry at Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust and a research fellow at the Royal College of Psychiatrists’ Research and Training Unit (CRTU, 4th Floor, Standon House, 21 Mansell Street, London E1 8AA, UK. Email: rchaplin{at}cru.rcpsych.ac.uk). His clinical work involves the assessment and management of adults with severe mental illness within the community mental health team and in-patient settings. He has interests in audit, the therapeutic alliance and mental capacity.

Enhancing a patient’s adherence to psychotropic medication regimens is one of the challenges facing all mental health professionals. Medication is part of an overall care package that often depends on patients’ engagement with the clinician or service. The therapeutic alliance might be improved by more active listening to patients. A reduced capacity may limit a patient’s ability to make a treatment choice. This can be improved by provision of more time and information. If these techniques are insufficient, closer monitoring may be achieved by working with relatives and carers, or more frequent visiting. Strategies to avoid covert non-adherence could include checking for picked up prescriptions and the use of depot preparations. Finally, the use of compulsory powers may be appropriate, with attention to preserving or rebuilding the therapeutic alliance.


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Why don’t patients take their medicine? Reasons and solutions in psychiatry
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APT 2007 13: 336-346. [Abstract] [Full Text]