Navigation Links
Coerced medication used in psychiatric care despite lack of clinical evidence
Date:12/4/2008

Researchers are calling for more studies into the practice of forcing psychiatric patients to take medication, after a research review showed that there have been very few rigorous investigations of the procedure.

The review, published in the latest Journal of Advanced Nursing, suggests that patients receiving coerced medication (CM) are more likely to be in their thirties with a diagnosis of schizophrenia, bipolar disorder or another psychotic disorder.

CM is used more often in the UK than in other countries where other forms of restraint are more common.

Most of the patients featured in the studies that were reviewed had been admitted to psychiatric care on an involuntary basis.

"It is clear from our review that there is little clinical evidence on the use of CM and more research is needed to examine all aspects of this contentious practice" says Manuela Jarrett, a registered mental health nurse from the Health Service and Population Research Department at the Institute of Psychiatry in London.

Jarrett, who co-authored the paper with Professor Len Bowers and Dr Alan Simpson from City University London, carried out a detailed analysis of 14 papers from seven countries, published between 1987 and 2004. These studies included interviews with 543 patients and 263 staff and analysis of 1,165 forms and records from the UK, USA, Sweden, Finland, Germany, Canada and Denmark.

"Legislation for involuntary psychiatric treatment exists in all European Union member states and in other western countries, where an increased risk to self and others provides the ethical and legal grounds for detaining and treating psychiatric patients without their consent" she says. "The fact that there is legislation in different countries suggests recognition of the seriousness and ethical uncertainty of such procedures.

"Perceived risk to others emerged as an important factor in the decision by staff to give a patient CM. But although half the researchers interviewed patients about their views on receiving CM, they didn't ask them whether they perceived themselves to be a risk to their self or others at the time when CM was administered.

"The studies showed that patients experienced a range of negative feelings when they received CM, including fear, embarrassment, anger and helplessness. Despite this, many said that they retrospectively agreed with the practice."

Research papers included in the review showed a notable lack of detailed exploration into the events leading up to the CM incidents and a complete absence of investigation into alternatives.

"This may reflect variations in the way conflict is managed in inpatients settings in different countries" suggests Jarrett. "CM is more likely to be used in the UK than in other countries, in which other forms of restraint such as seclusion or physical restraint are employed. Previous research by Professor Bowers showed that in some countries, such as the Netherlands, injecting someone against their will is seen as a serious violation of the body, yet the use of mechanical restraints is acceptable."

Jarrett and colleagues conclude that their review has highlighted a lack of clinical evidence on which to base CM, pointing out that the practice may discourage people from seeking help from, and engaging with, mental health services.

"Earlier and more effective interventions might be useful in minimising the use of CM, while better training in skills such as de-escalation strategies might also be valuable in avoiding coercion" says Jarrett.

The authors also feel that more research is needed into the use of CM.

"While there has been a lot of research into the pharmacological effectiveness of particular medications for quick and effective sedation, the reasons for the compulsory administration of powerful sedative and neuroleptic drugs have not been scrutinised closely or frequently. And there is little evidence that alternatives have been explored.

"The staff views reported in the literature and small number of studies available suggests that CM is a 'taken for granted' practice in inpatient psychiatry. We feel that this is unacceptable and more needs to be done to establish sound clinical evidence and viable alternatives to this contentious approach."


'/>"/>

Contact: Annette Whibley
wizard.media@virgin.net
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. APA Comments on FDAs First Approval of Medication to Treat Pediatric Schizophrenia and Bipolar Disorder
2. Manic phase of bipolar disorder benefits from breast cancer medication
3. AHRQ and FDA to Collaborate in Largest Study Ever of Possible Heart Risks with ADHD Medications
4. Mayo Clinic study indicates medication for ADHD may help student outcomes
5. Diet and medications may assist prevention of prostate cancer
6. Delmarva Foundation Implements Medication Therapy Management Program in Maryland and DC
7. Patient Safety Authority Releases Advisory Focusing on Common Causes of Medication Errors
8. Moses Taylor Hospital Automates Medication Reconciliation
9. Cautious Optimism for New Alzheimers Medications, Reports the Harvard Mental Health Letter
10. Patients cant recall their medications to tell doctors
11. Patient Empowerment -- Medication Error
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/29/2016)... ... 2016 , ... In an article published April 16th on the ... and lip injections, which she underwent in order to feel more at home at ... Festival. The article explains that Ms. Mirmelli’s situation is not unique; many plastic surgeons ...
(Date:4/29/2016)... ... April 29, 2016 , ... Shamangelic ... the addition Onnit brand Alpha BRAIN and New Mood Daily-Stress Formula for brain ... mood optimization products to the store is just one more way Shamangelic Healing ...
(Date:4/29/2016)... ... April 29, 2016 , ... The American workforce is on ... security. Most importantly, employees are the single most important asset in creating value ... unhappy? , Just under half of American workers are emotionally checked out with ...
(Date:4/29/2016)... ... , ... Conditions were ideal for Global Lyme Alliance’s (GLA) 2nd annual “Bite ... a light breeze and temperatures in the 60s. Over 400 runners, walkers and volunteers ... and 1-mile walk were held to increase awareness about Lyme disease and to ...
(Date:4/29/2016)... ... April 29, 2016 , ... Spine Team Texas, a comprehensive spine physician ... one of their physicians has been invited to be a featured speaker at the ... Review conference on April 30, 2016. , Dr. R. Scott McPherson, a physical ...
Breaking Medicine News(10 mins):
(Date:4/27/2016)... Switzerland , April 27, 2016 ... AG announced the launch of a Phase 2 clinical ... residual hearing in patients undergoing cochlear implantation (CI) surgery. ... recruiting patients in Germany and ... into the middle ear at the time of surgery. ...
(Date:4/26/2016)... 26, 2016 Hill-Rom Holdings, Inc. (NYSE: ... at the Deutsche Bank 41 st Annual Health Care ... You are invited to listen to the live ... access it directly at http://edge.media-server.com/m/p/mr4uxgas . A recorded replay ... of the live event and accessible at the links above ...
(Date:4/26/2016)... , April 27, 2016 Research ... "Global Molecular Diagnostics Market 2016-2020" report to their ... , ,The global molecular diagnostics market is projected to ... 2016-2020. Molecular diagnostics is a technique that ... the molecular level to detect changes in biochemical pathways. ...
Breaking Medicine Technology: