Using a treatment partner and text messaging to improve adherence to psychotropic medication: a qualitative formative study of service users and caregivers in Cape Town, South Africa

Type Journal Article - African journal of psychiatry
Title Using a treatment partner and text messaging to improve adherence to psychotropic medication: a qualitative formative study of service users and caregivers in Cape Town, South Africa
Author(s)
Volume 16
Issue 5
Publication (Day/Month/Year) 2013
Page numbers 364-370
URL http://www.ajol.info/index.php/ajpsy/article/download/94274/83656
Abstract
Objective: Poor adherence to medications, including psychotropic medications contributes to the burden of disease. Mental
health service users (MHSU) may also not attend follow-up appointments at their health care facilities where they could discuss
adherence with their health care provider. This paper reports on preliminary qualitative research preceding a randomised
controlled trial that aims to improve adherence to psychotropic medication and to follow up treatment visits. The intervention will
entail the support of individuals with serious mental disorder by a treatment partner and short message service (SMS) text
messaging. Methods: The preliminary research reported in this paper aimed to extract views about the intervention from both
mental health service users (MHSU) and caregivers through focus group discussions and individual interviews. Data were analysed
using ATLAS TI qualitative software. Results: The caregivers interviewed were all mothers of MHSU who took measures to
encourage adherence. They held mixed opinions on whether the treatment partner should be a family member. Most participants
expressed the view that due to living conditions, family members were natural treatment partners, but others stated that they would
prefer a treatment partner who was not a family member. Similarly, while most MHSU supported the idea of a treatment partner,
a minority were concerned that a treatment partner may potentially be too controlling and compromise their autonomy. The vast
majority of participants supported SMS text messaging as a means of reminding MHSU to take their medication and attend followup
appointments. One participant mentioned the importance of broader social inclusion issues that should be incorporated in the
intervention. Conclusion: Qualitative research may provide useful insights for the design of interventions of this nature related
to social inclusion randomised control trials with its focus on adherence.

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