Medication Adherence

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    • #11315

      I am just beginning my position within EPI, so have not yet had an experience faced with challenges about a client’s medication. When the time comes, I would ensure the client and their family had the appropriate information regarding side effects, as well as benefits to the medication in preventing relapse and mood management were discussed. I would explain that the psychiatrist will start on lowest dose and slowly increase to mitigate risk of side effects, and contact would be kept on regular basis to monitor symptoms and discuss concerns. The other important aspect would be ensuring to involve the family and the client’s support system in explaining the medication, its uses, and side effects. In regards to discussing potential sexual side effects with the client, I would gauge this with the client’s age and developmental level.

    • #11317

      Hi Victoria, you shared some great points.
      As a nurse I have had a lot of experiences working with medication management, especially in cases of psychosis from acute to chronic management.
      I think all of the points you shared are key in assisting with medication management in EPI.
      In my practice experiences one of the key components I found helpful was explaining why. I know this sounds simple but I feel it is commonly forgotten, for example yes the client has to do blood work on certain intervals though explaining why this needs to be done and the concerns if it is not definitely aides with compliance and their overall understanding of their own treatment which is crucial for their own wellbeing.
      I have also experienced a lot of clients who start medication and after the appropriate time feel better and stop taking medication because they feel they don’t need it as they are feeling fine. It is important to provide continuous education to the client and family, not just at the initial start as sometimes information is forgotten or needs to be communicated a few times in order for concrete understanding, to empower the client so they feel continuously involved in their care.
      One last piece I would like to share is some tactic to assist medication use including using an alarm to remind to take medications on time, blister packs with times or dates, pill organizers, or pill containers that unlock when next dose is due with a count down. It is also important to ensure client safety with medication such as use of a lock box, parents or family providing doses, or weekly dispensed medications to limit access is safety with medication is in question, collaborate with prescriber/client/family/care team for same as appropriate for best outcome.

      I appreciate how motivated you are to prevent relapse and provide fullsome medication education in your discussion post, as well as mentioning client capacity when considering same.
      I think also letting the client and family know where to go when to ask for information ongoing is helpful, such as pharmacy, care team, doctor, or researched based resources to normalize the continuum of ongoing education in regards to treatment. I have seen lots of stigma with clients or families feeling shameful when they have to ask information more than once or ongoing, in order to prevent this having these conversation could help.

      If anyone else have any experiences or thoughts from the readings to share further I would love to do some more reading and learning from others.
      Grace

    • #11329

      Hi Victoria and Grace,

      I am also new to EPI, so I am in a similar position as Victoria. I am just starting to encounter clients who struggle to take their medication. Currently, I have a client who does not want to take medication because they are concerned about their weight and appearance. This client has been bullied in the past, so it makes sense appearing a certain way is important to them. Grace, I found your suggestion to offer continuous/ongoing psycho-ed helpful. This client was not provided much information on why the medication changes their weight, and they might feel like they have more agency in responding to the side effects if they know why their body is changing in the first place. I also reviewed the suggestions for managing side effects that were provided in this module, and found a youth worker who would be able to help the client participate in regular exercise. Instead of trying to help this client not worry about weight, I want to support them in feeling like they have tools to know how to navigate side effects. I am happy to hear more suggestions on how to navigate medication non-compliance related to weight gain.

    • #11331

      Hi Victoria,

      I agree with you that I am also quite new to EPI, and I am currently working as a YCW in community, so I do not get that much information about clients in regard to medications. But, as a YCW, I have come across many clients that are either gaining a lot of weight rapidly, or are very lethargic due to the medications that they are taking, so they often express their concerns to me about the side effects of the medications, and I will go with them out into the community to get some exercise, or do a variety of different activities with them to get them out of the house. This helps them gain more motivation, because they always bring up that they leave the sessions feeling so much better.
      I have also not experienced any clients about discussing any sexual side effects, but in clinical discussions, a few nurses have brought up having some male clients that struggle with low libido, and the nurses try to be as understanding as possible.

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