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Doctor-Patient Dialogue for Recovery

Discussing Medication-Related Side Effects With Your Patient

Newer medications, psychosocial rehabilitation, family and peer support and integrated services have enabled a new level of functioning for people with mental illness. For many individuals, a key element that enhances their progress has been productive, two-way communication with their doctors or a Dialogue for Recovery.

One important focus of this dialogue is the role of medications in patients' recovery, and of the complicating factor of medication-related side effects.

Though some side effects may seem minor compared to the symptoms of a serious mental illness, patients may be bothered by these complications, and, as a result, may choose to alter or discontinue their medication regimens.

One way to help patients adhere to treatment is to build a Dialogue for Recovery about medication-related side effects. Here are some ways to approach this dialogue:

ASC is designed to be flexible. One approach to using ASC is to have patients complete it with their caseworker. You can then review the checklist with your patients during their next session. You can also complete ASC with your patients during an appointment by having an open dialogue with them about side effects. Either way, ASC can help you screen for distressing side effects that your patients are experiencing. ASC may also encourage your patients to talk about Dialogue for Recovery topics, such as sexual dysfunction, and to track their health between visits.Consider Using the Antipsychotic Side Effects Checklist  (page 5), or ASC. ASC is a user-friendly screening tool designed to improve communication between doctors and patients about the treatment of mental illness. ASC serves as a catalogue of common and distressing side effects associated with antipsychotic medications. The checklist can help you, your patients and members of a care team maintain a flow of information that can strengthen communication and collaboration. This may be helpful during titration or when deciding to change medications.

ASC was developed by a medical steering committee led by Peter Weiden, M.D., SUNY Health Science Center, Brooklyn, N.Y., and Alexander Miller, M.D., University of Texas Health Science Center, San Antonio, Texas.

Discuss pros and cons of medications. By discussing the beneficial and adverse effects of medications during visits, you can better prepare patients for any treatment challenges that may arise and foster a stronger doctor-patient relationship. Improved adherence to medication regimens can contribute to remission, quality of recovery, and fewer relapses and hospitalizations.

Display patient education materials in your waiting room. You may want to have the patient brochure "Recovery After a Diagnosis"displayed in your waiting room along with the ASC and other materials from the Mental Health America online store. Additional Mental Health America handouts such as "Giving Support to Someone Close to You" will help your patients and their family members understand the importance of open communication.

Address life goals with your patients. Talk with your patients about other support mechanisms that are helping them recover from mental illness. How are their relationships going? Are they satisfied with their job situation? Are they satisfied with their housing? Physicians and other healthcare providers can help patients with severe mental illness realize that recovery is possible, and that despite their illness they can set and reach their life goals.

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