Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: A qualitative study
Open accessAbstract
AIM: To explore and analyze perceptions of service users and caregivers on adherence and nonadherence to medication in a mental health care context. BACKGROUND: Mental health medication adherence is considered problematic and legal coercion exists in many countries. DESIGN: This was a qualitative study aiming to explore perceptions of medication adherence from the perspective of the service user (and their caregiver, where possible). PARTICIPANTS: Eighteen mental health service users (and six caregivers) with histories of medication nonadherence and repeated compulsory admission were recruited from voluntary sector support groups in England. METHODS: Data were collected between 2008 and 2010. Using qualitative coding techniques, the study analyzed interview and focus group data from service users, previously subjected to compulsory medication under mental health law, or their caregivers. RESULTS: The process of medication adherence or nonadherence is encapsulated in an explanatory narrative. This narrative constitutes participants' struggle to negotiate acceptable and effective routes through variable quality of care. Results indicated that service users and caregivers eventually accepted the reality of their own mental illness and their need for safety and treatment. They perceived the behavior of professionals as key in their recovery process. Professionals could be enabling or disabling with regard to adherence to medication. CONCLUSION: This study investigated service user and caregiver perceptions of medication adherence and compulsory treatment. Participants described a process perceived as variable and potentially doubly faceted. The behavior of professionals was seen as crucial in collaborative decision making on medication adherence.
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Therapeutic adherence is described as a fluid process that reinforces collaborative approaches between the patient and the clinician and improves the relationship with professionals, affecting satisfaction with treatment.
“Some articles described therapeutic adherence as a fluid process that reinforces the collaborative approaches between the patient and the clinician [38,56,76] and improves the relationship with professionals [46], affecting satisfaction with treatment [34,45,62,77,78].”
From Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis (2023) · cites this paper as [76]
Therapeutic relationships are commonly based on paternalistic views by both HCPs and users, especially when insight or acceptance of mental illness is absent.
“Nevertheless, therapeutic relationships are commonly based on paternalistic views by both HCPs and users, especially when insight or acceptance of mental illness is absent [76].”
From Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis (2023) · cites this paper as [76]
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- Authors
- Gault, I., Gallagher, & Chambers
- Affiliations
- St George's, University of London (GB)
- Corresponding author
- Gault, Iris
- ORCID
- Gault, Iris
- Venue
- Patient Preference and Adherence
- Publisher
- Informa UK Limited
- Published
- 2013-08
- Volume
- 7
- Pages
- 787
- ISSN
- 1177-889X (ISSN-L)
- PMC
- PMC3749064
- OpenAlex
- W2008081968
- Cited by
- 21
- References
- 47
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 3
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Patient Preference and Adherence (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Brunel University Research Archive (BURA) (Brunel University London) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Research Repository (Kingston University London) (submittedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Funders
- Kingston University
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- medication adherence, medication non-adherence, mental health law, legal coercion, service user perspectives, caregiver perspectives, mental illness, professional conduct, collaborative decision-making, involuntary admission
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