Transcript SELF MEDICATION PROGRAM - Centre on Behavioral Health

SELF MEDICATION
PROGRAM
PSYCHIATRIC REHABILITATION
WARD
Objectives



To develop and promote the
practice of taking drugs by self
at required time with the
accuracy of drug prescribed by
case medical officer.
To reinforce the importance of
compliance to treatment regime
To empower patients through
drug taking
Reasons

Non compliance to drug taking
is common in patients after their
discharge and causing recurrent
or relapse of the mental illness
Target patients


Patients who are members of
the Rehabilitation Oasis of the
Psychiatric Rehabilitation ward.
Patients who are mentally stable
and are preparing for discharge
and are referred by their case
nurses
Stages of the program
1. Individual interview by
respective case nurses

a. Patients learn the drug
prescriptions : know the drugs
by their name, both therapeutic
and adverse effects; dosage


b. Patient learn to read and
follow the instruction and
prescription written on the
plastic bags / bottles that
contain the drugs
c. Patient is able to get the exact
dosage of the drugs from the
plastic bags / bottles
2. During medication round
 a. Patients go to the respective
compartment of medication
trolley and get the drugs
according to the prescriptions
labeled on the plastic bag /bottle
with a plastic medicine cup




b. Patients have to tell the nurse
the names of the drugs and the
dosage
c. The nurse would check if the
drugs got are correct
d. Patients take the drugs after
confirmation by the nurse
e. Patients make a record on the
“Drug taken chart” afterwards
3. Evaluation with nurse / case
nurse after first three days of
self administration of drugs
4. Meeting with nurse / case nurse
if there is changes in the drug
prescription.


5. Upon home-leave / discharge
of patient, she has to reconfirm
the drug regime with the nurse /
case nurse
6. During home leave period,
the case nurse would provide
phone care service to
reinforcement the drug
compliance.
General psychotropic drugs







Neuroleptics / Antipsychotics
Mood stabilizers &
anticonvulsants
Antidepressants
Antiparkinsonian agents
Anxiolytic
Hypnotics / sedatives
Cognition-enhancers

(Each patients are encouraged
to discuss with their case nurse
on the types of drugs that you
are taking.)
Time of drug taking during
hospital stay





1. OM only : 0800
2. OM & noon : 0800 & 1200
3. BD : 0800 & 2000
4. TDS : 0800, 1700 & 2000
5. QID : 0800, 1200, 1700 &
2000
Time of drug taking in the
community


Advice to follow according to the
time frame used in the hospital;
Flexibility is allowed to fit in the
daily schedule
Reasons for non-compliance
after discharge




1. Attitude towards illness,
medication :
- limited insight / knowledge
about the illness & medication
2. Side effects of medication
3. Complex drug regime
4. Lack of supervision in the
community
Strategies to tackle the nonadherence


1a. Develop a habit of drug
taking at a time that is
incorporated in daily activities eg.
after meals, before going to bed.
1b. Use of tools / equipments as
reminders eg. pill boxes, record
card
Strategies to tackle the nonadherence


2a. Education on the signs and
symptoms of the various mental
illness (would be discussed in
another lecture)
2b. increase in understanding
the therapeutic effects of
medication on the mental illness
eg. decrease of signs and
symptoms after taking drugs
3. Common side effects of
drugs & strategies for coping
Side effect
Strategy for coping with it
Appetite
(increase)
Eat a diet that is low in fat and high in
fibre; avoid sugary or fatty food; drink
low-calorie soft drinks
Constipation
Increase exercise; increase fibre in
diet; increase fluid intake
Dizziness
Get up slowly from lying or sitting;
avoid excessively hot showers or
baths; avoid alcohol, sedatives or
other sedating drugs
Side effect
Strategy for coping with it
Drowsiness
Take medication in a single dose before
bedtime (talk to the doctor this first). If
you feel sleepy during the day, you
should not drive or work with machinery.
Dry mouth
Ensure regular fluid intake; limit alcohol
& caffine (both enhance water loss);
use sugarless gums, fruit pastilles &
lollies (sugar will promote dental decay);
suck on ice cubes.
Sensitivity to
sunburn
Avoid the midday sun; regularly use
sunscreen & wear a hat, sunglasses
and shirt; ask your doctor for a
prescription for sunscreen.
Strategies to tackle the nonadherence


4. Discuss with Case Medical
Officer about the possibility of
simplifying the drug regime
5. Encourage supervision from
family members / relatives /
friends / staff of NGOs. etc.
Importance of drug adherence


1. monitor and maintain a
stable mental condition
2. reduce recurrent or relapse of
the mental illness
Sharing, Questioning and
Answering time
THANK YOU