01 Apr How do I know if my behavioral health clients are adherent to their medications?
A reliable, objective way to determine if your clients are adherent to their medication regimen is to utilize AcuRise ID™, a urine drug testing tool designed by Aegis to monitor compliance for those being treated for mental illness and/or substance use disorder (SUD).
Mental illness is common in the United States, with an estimated 44.7 million people – nearly 1 in 5 adults – experiencing mental illness over the course of a year.1 Of those 44.7 million individuals, about 10.4 million experience a serious mental illness, equating to nearly 1 in every 25 adults.1 In addition to these staggering statistics, reports have shown a strong association between SUD and mental illness, with an estimated 10.2 million affected individuals.2
Despite medication having shown to be effective in the treatment of mental illness, on average, less than half of those with mental illness take their medications as prescribed.3 Research has reported clients with schizophrenia are adherent to their medications 10-76% of the time, clients with depression 28-52% of the time, clients with bipolar disorder 20-66% of the time, clients with anxiety disorders 57% of the time, and clients with attention deficit hyperactivity disorder (ADHD) 13-85% of the time.3-5 Research has determined risk factors for non-adherence include: young age, low level of education, male gender, low socioeconomic status, substance abuse or dependence, social/environmental factors, medication-related factors (e.g. adverse effects), and psychological factors such as cognitive impairment, poor insight, and denial of illness.4
Studies have shown that non-adherence increases risk of relapse, hospitalization, suicide, incarceration, and overall costs.6-7 Clients with a mental illness who are not adherent to their medications have a 77% chance of symptom recurrence after one year, and a 90% chance after two years.6 There are reports of over 190 billion dollars in lost earnings experienced each year by those with serious mental illness.8 These statistics raise many questions regarding ways to assess clients and improve adherence. One way to gain insight into your clients’ adherence is through AcuRise ID™, the behavioral health medication adherence monitoring test developed by Aegis.
AcuRise ID™ is a urine drug test designed for the unique needs of mental health and recovery care providers. Liquid chromatography/tandem mass spectrometry (LC/MS/MS) is utilized to definitively identify and quantify drugs and/or metabolites present in a urine specimen. This test is an objective tool to monitor medication adherence and promote the well-being of clients. By providing accurate, confident, and impactful laboratory results, AcuRise ID™ can assist providers in delivering optimized therapy options.
Clinicians have complete freedom to customize testing orders for specific client needs by ordering a la carte testing, one of Aegis’s testing profiles, or a combination of a la carte and profile testing. AcuRise ID™ has two comprehensive testing profiles available, a SUD profile and a mental health profile. The AcuRise ID™ SUD profile tests for more than 30 medications including amphetamines, benzodiazepines, and opioids. This can help providers identify clients that are taking illicit or prescribed substances that may hinder their recovery. The mental health profile includes more than 40 medications commonly used to treat schizophrenia, ADHD, anxiety, bipolar disorder, depression, and more, to identify adherence to medications.
NOTICE: The information above is intended as a resource for health care providers. Providers should use their independent medical judgment based on the clinical needs of the patient when making determinations of who to test, what medications to test, testing frequency, and the type of testing to conduct.
REFERENCES:
1. National Institute of Mental Health. Mental Illness. National Institutes of Health Website. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml. Updated November 2017. Accessed September 2, 2018.
2. Center for Behavioral Health Statistics and Quality.(2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/.
3. García S, Martínez-Cengotitabengoa M, López-Zurbano S, Zorrilla I, López P,Vieta E, González-Pinto A. Adherence to Antipsychotic Medication in Bipolar Disorder and Schizophrenic Patients: A Systematic Review. J Clin Psychopharmacol. 2016 Aug;36(4):355-71.
4. Ehret MJ, Wang M. How to increase medication adherence: what works? Mental Health Clinician. 2013;2(8):230-232.
5. Ahmed R, Aslani P. Attention-deficit/hyperactivity disorder: an update on medication adherence and persistence in children, adolescents, and adults. Expert Rev Pharamcoecon Outcomes Res. 2013; 13(6):791/815.
6. El-Mallakh P, Findlay J. Strategies to improve medication adherence in patients with schizophrenia: the role of support services. Neuropsychiatr Dis Treat. 2015 Apr 16;11:1077-90.
7. Collier L. Incarceration nation. Monitor on Psychology. 2014 Oct; 45 (9):56.
8. Insel TR. Assessing the economic costs of serious mental illness. Am J Psychiatry. 2008 Jun;165(6):663-5.