Advertisement

International Journal of Clinical Pharmacy

, Volume 33, Issue 4, pp 614–620 | Cite as

An exploratory study of the role of trust in medication management within mental health services

  • Ian D. MaidmentEmail author
  • Patrick Brown
  • Michael Calnan
Research Article

Abstract

Objective To develop understandings of the nature and influence of trust in the safe management of medication within mental health services. Setting Mental health services in the UK. Method Qualitative methods were applied through focus groups across three different categories of service user—older adult, adults living in the community and forensic services. An inductive thematic analysis was carried out, using the method of constant comparison derived from grounded theory. Main Outcome Measure Participants’ views on the key factors influencing trust and the role of trust in safe medication management. Results The salient factors impacting trust were: the therapeutic relationship; uncertainty and vulnerability; and social control. Users of mental health services may be particularly vulnerable to adverse events and these can damage trust. Conclusion Safe management of medication is facilitated by trust. However, this trust may be difficult to develop and maintain, exposing service users to adverse events and worsening adherence. Practice and policy should be oriented towards developing trust.

Keywords

Adverse events Concordance Health behaviour Mental health Qualitative research United Kingdom 

Notes

Acknowledgments

We acknowledge the co-operation of service users from Kent and Medway NHS and Social Care Partnership Trust in this research project.

Funding

None.

Conflicts of interest

IM has undertaken consultancy for pharmaceutical companies that produce medication used within mental health services including Eli Lilly, BMS, Lundbeck, Servier and Astra Zenecca. PB and MC none.

References

  1. 1.
    Möllering G. Trust: reason, routine and reflexivity. Oxford: Elsevier. 2006. ISBN 0080448550.Google Scholar
  2. 2.
    Hall MA, Dugan E, Zheng B, Mishra AK. Trust in physicians and medical institutions: what is it, can it be measured and does it matter. Milbank Q. 2001;79:613–39.PubMedCrossRefGoogle Scholar
  3. 3.
    Calnan M, Rowe R, Entwistle V. Trust relations in health care: an agenda for future research. J Health Organ Manag. 2006;20:477–84.PubMedCrossRefGoogle Scholar
  4. 4.
    Entwistle VA, Quick O. Trust in the context of patient safety problems. J Health Organ Manag. 2006;20:397–416.PubMedCrossRefGoogle Scholar
  5. 5.
    Brown P, Calnan M, Scrivener A, Szmukler G. Trust in mental health services: a neglected concept. J Mental Health. 2009;18:449–58.CrossRefGoogle Scholar
  6. 6.
    Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Soc Sci Med. 2000;51:657–68.PubMedCrossRefGoogle Scholar
  7. 7.
    Nunes V, Neilson J, O’Flynn N et al. Clinical guidelines and evidence review for medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners. 2009. Available on http://www.nice.org.uk/nicemedia/pdf/CG76FullGuideline.pdf. Accessed 7 Mar 2011.
  8. 8.
    Seale C, Chaplin R, Lelliott P, Quirk A. Sharing decisions in consultations involving anti-psychotic medication: a qualitative study of psychiatrists’ experiences. Soc Sci Med. 2006;62:2861–73.PubMedCrossRefGoogle Scholar
  9. 9.
    Safran DG, Taira DA, Rogers WH, Kosinski M, Ware JE, Tarlov AR. Linking primary care performance to outcomes of care. J Fam Pract. 1998;47:213–20.PubMedGoogle Scholar
  10. 10.
    EMERGE (Erice Medication Errors Research Group). Medication errors: problems and recommendations from a consensus meeting. Br J Clin Pharmacol. 2009;67:592–8.CrossRefGoogle Scholar
  11. 11.
    Vassilev I, Pilgrim D. Risk, trust and mental health services. J Mental Health. 2007;16:347–57.CrossRefGoogle Scholar
  12. 12.
    Maidment ID, Paton C, Lelliott P. A review of medication errors in mental health care. Qual Saf Health Care. 2006;15:409–13.PubMedCrossRefGoogle Scholar
  13. 13.
    Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.PubMedCrossRefGoogle Scholar
  14. 14.
    Buston K, Parry-Jones W, Livingston M, Bogan A, Wood S. Qualitative Research. Br J Psychiatry. 1998;172:197–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Department of Health. No health without mental health: a cross-government mental health outcomes strategy for people of all ages. London. Department of Health. 2011. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_123766. Accessed 7 Mar 2011.
  16. 16.
    Department of Health. Mental health national service framework (and the NHS Plan) workforce planning, education and training underpinning programme: adult mental health services: final report by the workforce action team special report. London: Department of Health. 2011. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4058912.pdf. Accessed 7 Mar 2011.
  17. 17.
    Charmaz K. Constructing grounded theory—a practical guide through qualitative analysis. London: Sage Publications; 2006. ISBN 9780761973539.Google Scholar
  18. 18.
    Wilder CM, Elbogen EB, Moser LL, Swanson JW, Swartz MS. Medication preferences and adherence among individuals with severe mental illness and psychiatric advance directives. Psychiatr Serv. 2010;61:380–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Maidment ID, Haw C, Stubbs J, Fox C, Katona C, Franklin BD. Medication errors in older people with mental health problems: a review. Int J Geriatr Psychiatry. 2008;23:564–73.PubMedCrossRefGoogle Scholar
  20. 20.
    Brownlie J, Howson A. Leaps of faith and MMR: an empirical study of trust. Sociology. 2005;39:221–39.CrossRefGoogle Scholar
  21. 21.
    Kadam UT, Croft P, McLeod J, Hutchinson M. A qualitative study of patients’ views on anxiety and depression. Br J Gen Pract. 2001;51:375–80.PubMedGoogle Scholar
  22. 22.
    Warner L, on behalf the Sainsbury Centre for Mental Health. Briefing 21—choice in mental health care. 2006. Available on http://www.scmh.org.uk/pdfs/briefing31_choice_in_mental_health_care.pdf. Assessed on 7 Mar 2011.
  23. 23.
    Goodwin S. Independence, risk and compulsion: conflicts in mental health policy. Soc Pol Admin. 1997;31:260–73.CrossRefGoogle Scholar
  24. 24.
    Altice FL, Mostashari F, Friedland GH. Trust and the acceptance of and adherence to antiretroviral therapy. J Acquir Immune Defic Syndr. 2001;28:47–58.PubMedGoogle Scholar
  25. 25.
    Bollini P, Tibaldi G, Testa C, Munizza C. Understanding treatment adherence in affective disorders: a qualitative study. J Psychiatr Ment Health Nurs. 2004;11:668–74.PubMedCrossRefGoogle Scholar
  26. 26.
    Fogarty JS. Reactance theory and patient non-compliance. Soc Sci Med. 1997;45:1277–88.PubMedCrossRefGoogle Scholar
  27. 27.
    Sellwood W, Tarrier N. Reactance and treatment compliance in schizophrenia. Acta Psych Scand. 2002;106:s 413. doi: 10.1034/j.1600-0447.106.s413.1_127.x.CrossRefGoogle Scholar
  28. 28.
    Reason J. Human error. Cambridge: University of Cambridge; 1990. ISBN—9780521314190.Google Scholar
  29. 29.
    Watt I, Birks Y, Entwistle V et al. Patient safety research programme PS/034—a review of strategies to promote patient involvement, a study to explore patient’s views and attitudes and a pilot study to evaluate the acceptability of selected patient involvement strategies. University of York, May 2009. Available on—http://www.haps.bham.ac.uk/publichealth/psrp/documents/PS034_-_Final_report_2009.pdf. Accessed 9 Mar 2011.

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Ian D. Maidment
    • 1
    • 2
    Email author
  • Patrick Brown
    • 3
  • Michael Calnan
    • 4
  1. 1.Pharmacy Department, Kent and Medway NHS and Social Care Partnership TrustEastern and Area Coastal Office, St Martin’s HospitalCanterbury, KentUK
  2. 2.Centre for Health Services StudiesUniversity of KentCanterburyUK
  3. 3.Department of Sociology and AnthropologyUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.School of Social Policy, Sociology and Social ResearchUniversity of KentCanterburyUK

Personalised recommendations