Poster Presentation
Monday, November 5, 2007
10:30 AM - 11:45 AM
Monday, November 5, 2007
1:30 PM - 2:45 PM
Dual Goal Attainment in Schizophrenia: Medication Adherence and Reduction in Substance Use
Deborah Finnell, DNS, RN, NPP, School of Nursing, University at Buffalo, Buffalo, NY, USA and Stefania Fynn-Aikens, RN, MS, Outpatient Behavioral Health, Lakeshore Behavioral Health Inc, Buffalo, NY, USA.
| Learning Objective #1: 1. State two interventions for removing barriers to, or enhancing effective strategies for dual goal attainment in the target population. |
| Learning Objective #2: 2. Propose nursing strategies for integrated treatment for the target population. |
About 50% to 70% of individuals with schizophrenia also meet the criteria for substance abuse. Estimates suggest that persons with substance abuse disorders are greater than eight times more likely to be medication noncompliant. Thus, it is important to encourage individuals with schizophrenia and comorbid substance use to work toward goal attainment: medication adherence and reduction in substance use. This is underscored by evidence that there are favorable outcomes for individuals with schizophrenia who are not abusing alcohol and other drugs and who are adhering to prescribed medications. Psychiatric medications are intended to alleviate distressful symptoms associated with schizophrenia. Yet, despite taking psychiatric medications, symptoms may not be effectively ameliorated and troublesome side effects may be experienced. Alcohol and illicit drug use may relieve distress, but can also worsen symptoms associated with schizophrenia. A systematic review of studies was conducted to identify factors that hinder and facilitate dual goal attainment for this population. Twenty-one studies met the inclusion criteria for the review. Five themes constituted facilitating factors: integrated treatment, pharmacotherapy, treatment involvement, therapeutic relationship, and supportive family / significant other. Four themes constituted hindering factors: limited insight, symptomatology, external influences, and prescribing practices. However, only three studies measured both medication taking and substance using behaviors in their study sample. While integrated treatment programs are touted as the gold standard for this population, nursing interventions can be provided during any contact with these individuals. Nurses who interact with this population can intervene to enhance effective strategies and remove barriers for individuals with schizophrenia and comorbid substance use attain these clinically relevant goals.