Patients' perceptions of information received about medication prescribed for bipolar disorder: Implications for informed choice

Abstract

Background

Previous research suggests that patients are dissatisfied with information provided about medication prescribed for mental illness, but has not identified which aspects of information provision are unsatisfactory.

Methods

223 members of the Manic Depression Fellowship (MDF) completed the Satisfaction with Information about Medicines Scale (SIMS), a validated measure of patients' satisfaction with various aspects of information provision.

Results

Patients reported highest dissatisfaction with information about potential problems associated with medication; over 60% of participants reported dissatisfaction with information about the risks of side effects and whether the medication would affect their sex lives. Participants were significantly less satisfied with information about potential problems associated with their medication than people prescribed medication for HIV in a previously reported study (p < .01). Those reporting low adherence to medication had significantly lower satisfaction with information scores than those reporting high adherence (p < .05).

Limitations

The sample could be prone to selection bias; participants were members of an organisation for people affected by bipolar disorder, whilst the comparator group was a NHS HIV clinic sample. Furthermore, the objective amount and type of information provided was not assessed, therefore the cause of patients' dissatisfaction is not known.

Conclusions

Perceived satisfaction with information is low, particularly in relation to possible drug side-effects. Health practitioners need to elicit individuals' information requirements and tailor information to meet their needs, in order to facilitate informed choice and adherence to treatment. Moreover, they need to provide information in a manner appropriate for a patient's cognitive functioning at different illness phases.

Introduction

In order to make informed decisions about medication patients require adequate information. Research suggests, however, that patients may be dissatisfied with information received about medication prescribed for mental illness. For example, in a survey of over 2500 members of the Manic Depression Fellowship, National Schizophrenia Fellowship and MIND, 27% of participants reported that their doctors had not talked to them about their medication. Comparable results emerge from inpatient studies, with one reporting that just 61% of patients agreed with the statement “Doctors have explained my treatment clearly to me” (Barker et al., 1996).

Information provision is not exclusively the responsibility of doctors; patients in the UK are cared for by multidisciplinary mental health teams and it is likely that information will come from a variety of sources, including doctors, psychiatric nurses, pharmacists, social workers and support workers. Indeed, following the introduction of non-medical prescribing, patients are increasingly prescribed medication by Nurse and Pharmacist Independent Prescribers. However, studies which have not focussed specifically on satisfaction with information provided by doctors have found similar results. For example, in a questionnaire study completed by 69 patients receiving secondary care for a diagnosis of schizophrenia, 46% reported that they had not been warned about potential side effects of medication (Gray et al., 2005). Similarly, in an interview-based study involving 84 outpatients with a diagnosis of schizophrenia, 56% reported not having received enough information about their medication (Paton and Esop, 2005).

Whilst there is clearly a need to address information provision for patients with mental illness, it is not yet known which specific aspects of information about medication patients find inadequate. The present study used a validated questionnaire (Horne et al., 2001) to profile patients' satisfaction with information about medication prescribed for bipolar disorder.