Factors Affecting Compliance for Patients Post First Episode Psychosis

Abstract

Aims

Psychosis is a symptom of various health disorders characterised by hallucinations and delusions. Medication and appointment compliance amongst sufferers of psychosis remains a major issue. The aim of this study is to explore factors affecting compliance to inform interventions for improving service quality.

Methods

A rapid systematic review was conducted on PubMed. Following screening, these papers were extracted and assessed using the hawker tool. 161 papers were identified with a search criterion and 33 were screened after removing non- English records, paid articles and pre-2015 papers. Abstracts of 33 papers were screened and 9 studies were looked at in detail.

Results

33 papers were identified after establishing a search criterion, from this 9 progressed to the inclusion stage. After using the Hawker tool, the quality of the papers averaged 32.8/36 and several significant factors were identified. The most significant factors that affect compliance are: insight, type of treatment, early signs of psychosis, ethnicity, income and qualitative factors.

Conclusion

Various measures can be suggested to help improve medication and appointment adherence for service users. Improving insight through targeted-informative leaflets on medication available at first contact with the Psychiatrist or GP. More frequent medication reviews for select patient groups identified with a higher risk of non-adherence. Greater income assistance through food and travel vouchers or information on how funding can be accessed. Lastly, staff training on increasing insight for psychosis patients delivered through a 1-day course/e-learning module.