Mental health articles

OF mental health care and mentally ill

The rationale for interventions

Although the literature exploring the benefits of improved medication compliance is limited, there is a strong rationale for addressing this area for the following reasons.

The first is a moral-ethical one, related to symptom reduction/relief and improving and maintaining the perceived quality/quality of life of the client; taking into account the holistic needs of the individual, a cost-benefit analysis of the prescribed medication and an awareness that improvement of health may not always be a motivating factor. The second is related to the impact of adverse reactions to medication. General studies have identified that a high proportion of all hospital admissions, general practitioner and outpatient consultations are a result of the impact of non-compliance and, or, adverse drug reactions. The third is related to costs of health and social care. The direct cost of schizophrenia in England and Wales is estimated to be in excess of £1 billion, with drug costs accounting for 5 per cent of this sum. In 1992 £76 million was spent on 1.2 million annual prescriptions for schizophrenia, with a week on a psychiatric ward costed at £960, community support £230 and a 30-day prescription for the atypical drug olanzapine costed at £209. In 2002 overall prescription costs rose to £6.1 billion, one-tenth of all NHS spending, with £230 million of medicines returned to pharmacies and an uncalculated cost/amount being privately disposed of . There are also indirect costs: the costs of caring, loss of employment and the loss of active citizenship. In 1990/1 the indirect costs of schizophrenia in the UK were estimated to be at least £1.7 billion .

From the evidence there is obviously a clear rationale for careful, individual tailored prescribing and support in improving the quality of life for people receiving prescribed medication treatments. There is also the added potential of a positive effect in reducing direct and indirect costs.

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