Young adults diagnosed with schizophrenia.
Schizophrenia affects a patient’s ability to think and feel and negatively influences their behavior. It is a debilitating disorder affecting less than 1% of the US population. A critical barrier to schizophrenia treatment involves the client’s resistance, whether due to denial, shame, stigma, or their disorder’s particular symptoms. For example, because schizophrenia patients often experience paranoia, delusional beliefs, and negative symptoms like alogia, anhedonia, and catatonia, a potential client may have difficulty trusting others and accepting help. In addition, for the most part, in younger patients diagnosed with schizophrenia, antipsychotic medications decrease their sex drive and increase their prolactin level, which leads to medication non-compliance (Morken, Widen, & Grawe, 2021). The sides effect often affect the patient’s quality of life.
Schizophrenia is a chronic mental severe disorder often treated with first and second-generation antipsychotic agents, such as risperidone, Thorazine, aripiprazole, quetiapine, and ziprasidone. In comparison, patients hospitalized for schizophrenia disorder receive these agents at discharge but stop taking the medications due to sigma, denial, or side effects. The process of relapses, treatment failure, and incomplete recovery leads many patients to more severe issues and chronic illnesses (Tandon, Nasrallah, & Keshavan, 2020). Research indicates that progression is characterized by measurable brain volume deterioration and loss if left untreated. (Bonilha et al., 2019).
Non-compliance to pharmacological treatment can be subdivided into two classes: complete cessation of medication and partial non-adherence. These issues lead to significant complications such as behavioral disturbances, substance abuse, and death. An expert consensus statement endorsed the percentage of medication not taken over a while as the preferred definition of non-adherence. The experts agreed that patients taking at least 80% of prescribed medication might be considered fully adherent, those taking 50-79% are partially adherent, and those taking less than 50% are nonadherent. (Bonilha et al., 2019).
In addition, non-adherence to antipsychotic drugs in young adults with schizophrenia increases the rate of early re-hospitalization and involuntary admissions in the psychiatric wards to 30%. How can NPs manage this problem after discharging patients to ensure they take their medications? (Novick, Haro, Suarez, Vieta, & Naber, 2019).
Significance of the problem:
According to studies, non-adherence results in partial or no response to antipsychotic treatment have negative consequences, including a higher mortality rate. In effect, non-adherence to antipsychotic medicines in patients with schizophrenia leads to frequent relapse, multiple re-admission, and, worse, suicide. Furthermore, patients with first-episode schizophrenia, especially young adults, experience numerous barriers to treatment; therefore, increasing adherence to antipsychotic drug therapy is a must in this group. (Peng et al., 2019).
This project aims to monitor and reduce non-adherence to antipsychotic medications in young patients. The long-acting antipsychotic medication is beneficial and does not require patients to take it daily.
P: Young adults diagnosed with schizophrenia
I: Educate the patient about long-acting medication, and meet with the patient every two weeks for the first two months after taking the first dose. Then once a month for three months, the injections can be given in the clinic to ensure the patient takes the medication.
C: Lack of follow-up with patients after discharge
O: Decrease hospitalization by 20-30%.
T: Six months
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