ESCP edition:34 location:Amsterdam, Netherlands date:26-29 October 2005
Background and Objective:
The lack of information about prescription drugs is one of the main reasons why 30% to 50% of patients fail to comply with prescribed regimens, leading to drug-related morbidity and hospital admissions, thus generating additional health care costs.1 The aim of this literature study is to explore the impact of information interventions about medicines for psychiatric patients on compliance, knowledge and economic, clinical and humanistic outcomes (the ECHO-model).
Studies were identified from eight electronic databases (PubMed, PsycInfo, Current Contents, Science Direct, Cochrane Library, CINAHL, IPA and Ingenta), reference lists of included studies and primary studies included in reviews. Data analysis and assessment of methodological quality were executed according to the Cochrane Collaboration guidelines.
Psychiatry including inpatients and outpatients.
Main outcome measures:
Impact of medication information on compliance, knowledge, economic, clinical and humanistic outcomes.
Eighteen studies met our inclusion criteria. Nearly all studies quantified process measures such as compliance and knowledge. Little interest was observed in clinical and humanistic outcomes. None of the studies carried out an economic evaluation of the intervention.
With regard to compliance, combination of oral and written information seems to have an added value in comparison with exclusively oral or written information supply. Generally, compliance was 11-30% higher in the intervention groups versus the control group. The provision of easy readable written information improved compliance by 11%. Participants gained knowledge in most of the studies, independent of format. Knowledge was 14-28% higher in interventions groups in comparison with control group. For experimental patients, knowledge increased by 21-34% after provision of medication information as compared to 8-15% in control patients. Only limited evidence of success is available regarding report of side-effects and satisfaction. No significant differences were seen for relapse or admission rates, symptoms and quality of life.
The included studies suggested a positive impact on compliance and knowledge and a limited impact on side-effects and satisfaction. These improved outcomes should incentivise clinicians to inform their patients about their medication. Based on these improved outcomes, an intervention study will be performed, aiming at the cost-effectiveness of information to psychiatric patients when discharged from hospital.
1 American Family Physician 1995; 52(8): 2377-82