Psychotic disorders, such as schizophrenia and bipolar disorder with psychotic features, impact around 2% of the American population. These disorders can be effectively managed with the use of psychotropic medications to alleviate symptoms like hallucinations and delusions, as well as behavioral therapy focused on social skills training and hygiene maintenance.
Despite the effectiveness of these treatments, individuals with psychotic disorders exhibit the lowest level of medication compliance compared to those with mood or anxiety disorders. This noncompliance can be attributed to the significant side effects of antipsychotic medications, including involuntary muscle movements, blurred vision, and weight gain. Additionally, these medications need to be taken frequently and at high doses to achieve the desired therapeutic effect. The underlying reasons for noncompliance remain largely unknown, but research suggests a positive correlation between the age of schizophrenia diagnosis and medication compliance. Moreover, evidence indicates that medication noncompliance is more prevalent among individuals with a low socioeconomic status (SES) due to factors such as homelessness, lack of insurance benefits, and insufficient familial or social support.
To investigate the impact of drug education on medication compliance based on socioeconomic status, researchers conducted a study involving 1200 mentally ill individuals in the Los Angeles metro area. The study involved measuring the baseline compliance with psychotropic medications, providing the patients with a free educational seminar on drug therapy, and then assessing medication compliance six months later. The seminar, which lasted for one day and eight hours, covered topics such as the positive effects and side effects of psychotropic medications, interactions with other substances like alcohol and non-prescribed drugs, and information on accessing Medicare benefits. Compliance was measured by comparing the number of prescribed medication doses taken by the patients per week over a 12-week period to the number of doses recommended by their doctors. A self-report questionnaire was used to gather compliance data.
The results revealed that mentally ill patients from middle or upper class backgrounds (Upper and Middle SES) exhibited significantly higher compliance with their psychotropic medication regimens following the seminar, compared to before the intervention. However, no significant differences in compliance were observed among patients at or below the poverty level (Lower SES). Table 1 provides details on psychotropic medication compliance categorized by socioeconomic status and disorder.
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