Medication compliance: A comparison of the views of severely mentally ill clients in the community, their doctors and their case managers

Abstract

Judgements concerning psychiatric clients' adherence to medication regimes may vary according to whom one asks, but little is known about the agreement between informants. In this study, independent ratings of compliance were obtained from doctors, case managers and clients with serious mental illness in receipt of community psychiatric services. The majority of clients were compliant according to all three information sources. The agreement between doctors and case managers was strong, but much weaker between them and their clients. Rated compliance was not related to age or gender, but clients who were on statutory compulsory treatment orders, and who received their medications by injection, were more likely to be rated as non-compliant. Clients who refused an interview were rated by staff as less compliant, and were more likely to be on compulsory treatment orders. One in eight clients who rated themselves as less than fully compliant were thought by their doctors and case managers to be compliant.