Presentation is loading. Please wait.

Presentation is loading. Please wait.

A Pilot Study of Satisfaction and Adherence with Antipsychotic Medication Amongst Prisoners Dr Alice Mills Mr Dan Bressington Dr Richard Gray Professor.

Similar presentations


Presentation on theme: "A Pilot Study of Satisfaction and Adherence with Antipsychotic Medication Amongst Prisoners Dr Alice Mills Mr Dan Bressington Dr Richard Gray Professor."— Presentation transcript:

1 A Pilot Study of Satisfaction and Adherence with Antipsychotic Medication Amongst Prisoners Dr Alice Mills Mr Dan Bressington Dr Richard Gray Professor Judith Lathlean

2 Background – Prevalence of Mental Health Problems  Over 90% of prisoners have one or more mental disorders (including substance misuse) (Singleton et al. 1998) 54% male remand prisoners 44% male sentenced prisoners 61% female remand prisoners 42% female sentenced prisoners have three or more disorders  Between 7% and 14% of prisoners have functional psychosis in comparison to 0.4% of the general population

3 Adherence with Antipsychotic Medication  Estimated prevalence of non-adherence in community settings ranges from 24% to 80%  Non-adherence is a major cause of increased symptoms and relapse  Relapse rates:  One year relapse rate for patients with psychosis who are adherent with treatment is about 20% – 30%  One year relapse rate without medication is around 70%

4 Adherence with Antipsychotic Medication  Poor adherence associated with re- hospitalisation, poor outcomes and high economic costs  In forensic settings refusal of medication is associated with disturbed and violent behaviour.  Symptoms may go undetected on prison wings  Risk to self, staff and other prisoners  Potential contribution to recidivism

5 Adherence with Antipsychotic Medication  Treatment adherence is a complex health behaviour affected by several factors such as efficacy of treatment, side effects and beliefs/attitudes about treatment.  No previous studies examining non- adherence with antipsychotics in prisoners

6 Study Aims  Estimate the point prevalence of non- adherence to antipsychotics in prisoners  Determine prisoners’ satisfaction with and beliefs and attitudes towards antipsychotics  Identify predictors of adherence  Explore subjective experiences of medication  Act as a pilot for a larger study

7 Research Design  Observational cross sectional survey of treatment non-adherence with antipsychotic medication  Chosen prisons should provide a sample broadly representative of the general prison population  HMP Bronzefield – female local  HMP Brixton – male local  HMP Winchester – male local and cat C  Running parallel to the in-reach research study

8 Relationship to the In-Reach Study  Three year project undertaken in several prisons including Bronzefield and Winchester  Aims to provide evidence about the success and effectiveness of the in-reach initiative to improve the mental health care of prisoners  Clinical interviews identify those prisoners with severe mental illness who are prescribed antipsychotic medication

9 Inclusion Criteria  Aged over 18  In prison for at least a month  Capacity to give written informed consent  Absence of organic brain disease or severe learning disability  Prescribed (but not necessarily adherent with) any antipsychotic medication for at least 8 weeks

10  To minimise disruption, information gleaned from the in-reach study interview is used to complement data from the current study  Participants at HMP Brixton are recruited with the help of a consultant psychiatrist

11 Data Collection - Interviews  Self-report and interviewer rated measures to assess: Adherence Satisfaction with treatment (SWAM) Insight into illness (ISP) Psychopathology (BPRS) Attitudes and beliefs towards treatment (DAI) Side effects of treatment (LUNSERS)  Facilitates comparison between responses  Determines associations with adherence/non- adherence

12 Data Collection - Interviews  Short qualitative interview  Addresses themes of: Past experiences of medication Current views of medication Satisfaction with treatment Relationships with mental health professionals Methods of medication avoidance  Flexible and responsive topic guide  Aims to provide rich, contextual data about participants’ views and experiences

13 Data Collection – Case Note Analysis  Analysis of IMRs, mental health and general prison records to determine possible predictors of adherence including: –Demographics –Prison characteristics –Health service factors –Illness characteristics –Medication –Violence/behavioural disturbance

14 Progress So Far…  Recruitment started in July for HMP Bronzefield and in August for HMP Winchester  Recruitment started in September for HMP Brixton  Participants prescribed a variety of different antipsychotics  Recruited only 16 participants so far  We aim to recruit a total of 90 participants (somewhat optimistic!)  Alternative recruitment strategies

15 Working with Prisons in Mental Health Research  Barriers: Gaining access to prisons Navigating the research governance process with a private healthcare provider Limitations (due to service issues) on research time

16 Practical Challenges  Obtaining rooms to carry out interviews and ensuring that officers escort prisoners from their cells  Prison officer staffing levels  Non-attendance  Recording equipment

17 A Pilot Study of Satisfaction and Adherence with Antipsychotic Medication Amongst Prisoners Dr Alice Mills – Mr Dan Bressington Dr Richard Gray Prof Judith Lathlean


Download ppt "A Pilot Study of Satisfaction and Adherence with Antipsychotic Medication Amongst Prisoners Dr Alice Mills Mr Dan Bressington Dr Richard Gray Professor."

Similar presentations


Ads by Google