Maximizing Treatment Success for Patients with SMI: Promoting Adherence and Treatment Engagement-View Presentation

Video Transcription

Video Summary

The webinar, led by psychiatric experts Amber Hoberg and Dr. Donna Rowland, focused on maximizing treatment success for patients with serious mental illness (SMI) by promoting adherence and engagement. It began by defining non-adherence—patients not following prescribed treatment plans—and noting that about 50% of individuals with SMI (including schizophrenia, bipolar disorder, and treatment-resistant depression) are non-adherent, which impacts symptom management, quality of life, and increases hospitalizations and healthcare costs. Causes of non-adherence range from complex regimens, side effects, cognitive impairments, to beliefs about medication. Strategies to improve adherence include using long-acting injectable medications (which provide steady medication levels and reduce daily pill burden), psychoeducation, medication monitoring tools, and frequent patient contact. The importance of therapeutic alliances and shared decision-making between patients and providers was emphasized to build trust and improve engagement. Family involvement, peer support, and addressing co-occurring substance use were highlighted as crucial recovery supports. The presenters also discussed how to approach medication refusal respectfully and ethical considerations in treatment decisions. Practical methods for managing adherence in clinical settings, including utilizing nurse-administered injectables and pharmacy support, were reviewed. Finally, an easy-to-administer side effect rating scale was introduced to monitor medication burden. The session concluded with Q&A addressing clinical challenges related to adherence and patient-centered care in SMI.

Keywords

serious mental illness

treatment adherence

non-adherence causes

long-acting injectables

psychoeducation

therapeutic alliance

shared decision-making

medication side effects