Balisong, Rylina Olga Mae L.

03/ 01/ 2019

3NUR-2 RLE 1 Ma’am La. Arnie M. Lazalita, MAN, RN

Bibliography
Krzystanek, M. K. (2017). Treatment Compliance in the Long-Term Paranoif
Schizophrenia Telemedicine Study. Journal of Technology in Behavioral
Science, 84-87.

I. Statement of the problem

Compliance to the pharmacological treatment of schizophrenia is
essential to control the symptoms and prevent the relapse. Also, early
discontinuation of the said treatments would likely result to relapses,
drug intolerance and resistance as well. There were attempts to explore
and improve the compliance of schizophrenic patients. And, this study
aims to establish the treatment compliance level in schizophrenic
patients and show how telemedicine system can influence their
compliance. The limitation of the study was that not all confounding
factors were controlled for.

II. Research Methodology

The clinical study was performed on 199 patients in a 12-month
period. The group consisted of paranoid schizophrenia patients, were in
the symptomatic remission, and with stable pharmacological treatment.
Forty five (45) psychiatrist treated these patients, and used tablets to call
the clients’ smartphones with preinstalled Telemedicine MoneoPlatform.
This platform was validated for a month in a group of ten selected
psychiatrists with at least 5 years of clinical experience. The applications
functionalities are as follows: videoconferencing, compliance
monitoring, cognitive training, video education, psychometric
assessment, and electronic medical files recording. The platform kept
sending to the patient reminders about the drug intake, these reminders
came in twice – an hour before and right in the time of medicine intake;
if they already took the drug. Once answered by the patient it records
every confirmation. Lastly, the psychiatrist conducts a monthly
videoconference and discusses the compliance record with the patients.

III. Summary of Findings

Compliance rate was low from the beginning of the study and
showed no significant improvement over the 12-month study period.
Moreover, in the first month of the study, only 47.6% of the doses as
 taken were confirmed. This number decreases by 18.8% after 12
months of observation.

IV. Conclusions/ Recommendations

As of press time, the study is the biggest long-term study of
treatment compliance in schizophrenia, and performed on a large
number of patients. As stated in the results of the study, the compliance
rate from the very beginning was low this finding should’ve been a sign
for the researchers to be assertive in the use of the telemedicine
platform. Further, the use of telemedicine should have been
advantageous to these clients provided that their level of motivation was
assessed prior to the long-term study. Lastly, the researchers should
have slightly modified some parts of their interventions because as they
stated treatment compliance of schizophrenic patients is essential to
prevent relapses, drug resistance and intolerance.

V. Implications
The tool in the study can be used by student nurses, and
researchers in measuring the compliance of patients not limited to those
who are mentally ill. Further, the administration can seek help from
information technologists to help improve the platform and further
increase client’s treatment compliance. And, not only psychiatrists can
use the said platform, but also nurses who frequently interacts with the
patients.

VI. Reason for choosing the study

The reason I chose this article was due to curiosity about the
compliance of mentally ill patients to their medications in the long run
assuming they were allowed to be discharged from the institution they
once were confined in. Further, in a world wherein technology is
continuously modernizing the incorporation of telemedicine in this study
was a brilliant idea. At hindsight, the utilization of technology in this study
would actually boost the compliance of patients in their medications
because a program was established for their own use. However, the
study revealed otherwise. This was one of the reasons why I chose this
study because, compliance to their medications is part of one’s
treatment and rehabilitation. Moreover, having an idea that some clients
are non-compliant to their medications in the long run we can actually
provide alternative solutions for the gap that was discovered in this
study.