SELF-ADMINISTRATION OF MEDICATION BY PSYCHIATRIC INPATIENTS

Abstract

Nineteen male and 21 female psychiatric inpatients, aged 15 to 66, on moderate to high daily doses of chlorpromazine or imipramine, were randomly subdivided into four groups of 10 patients each. The groups differed in mode of drug administration. Drugs were self-administered with or without instruction, and were also administered in the traditional manner by nurses with or without instruction. Although the overall incidence of drug defaulting (24 per cent) was consistent with previous reports, patients on self-administration schedules revealed greater evidence of drug defaulting than did nurse-medicated patients. Contrary to expectations, instructions by nursing staff apparently undermined rather than supported patients' attitudes toward and adherence to prescribed medication. Although drugtaking behavior did not change over time, patients showed increasing preference for self-administration. Results are discussed in terms of patient responsibility and the responses of nurses to changes in an important aspect of their traditional role.