Community Health Workers: a Resource to Support Antipsychotic Medication Adherence
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Community health workers (CHWs) are frontline public health workers who are becoming increasingly integrated into medical settings for the prevention, treatment, and control of chronic disease. In particular, they have demonstrated the ability to improve medication adherence in underserved populations. One overlooked population that could benefit from CHW intervention is individuals with severe mental illnesses such as schizophrenia and bipolar disorder. These conditions are disproportionally weighted to economically disadvantaged communities and people of color, and are typically treated using antipsychotic medications. A number of factors, including social disadvantage, contribute to antipsychotic non-adherence, which is highly prevalent and drastically increases the burden of illness and economic impact of these conditions. This commentary examines the ways in which CHWs may be able to best serve individuals with severe mental illness, and proposes methods for facilitating this expanded scope of work.
KeywordsSchizophrenia Bipolar Disorder Antipsychotic Medication Severe Mental Illness Community Health Worker
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.IMS Health. Top Theraputic Classes by U.S. Spending. IMS. Available online at: http://www.imshealth.com/deployedfiles/imshealth/Global/Content/Corporate/Press Room/Top_line_data/Top_Therapy_Classes_by_Sales.pdf. Accessed September 22, 2015.
- 17.Brownstein JN, Allen CG. Addressing chronic disease through community health workers: a policy and systems-level approach; Centers for Diseaes Control and Prevention, 2015. Available online at: http://www.cdc.gov/dhdsp/docs/chw_brief.pdf. Accessed May 11, 2016.
- 18.American Public Health Association. Policy Number 20091: Support for community health workers to increase health access and to reduce health inequities [online]. Available online at: http://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/09/14/19/support-for-community-health-workers-to-increase-health-access-and-to-reduce-health-inequities. Accessed January 6, 2013.
- 20.Findley SE, Matos S, Hicks AL, et al.. Community health worker integration into the health care team accomplishes the triple aim in a patient-centered medical home: a Bronx tale. Journal of Advanced Nursing 2014;37(1):82–91.Google Scholar
- 25.Wennerstrom A, Vannoy S, Allen CE, et al. Community-based participatory development of community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans. Ethnicity and Disease 2011;21(3 Suppl 1):45–51.Google Scholar
- 26.O’Riordan M. Use of Community Health Workers Improved Adherence following ACS. Paper presented at: World Congress of Cardiology Scientific Session, Melbourne, Austraila, 2014.Google Scholar
- 27.The Community Guide. Cardiovascular Disease Prevention and Control: Interventions Engaging Community Health Workers. Available online at: http://www.thecommunityguide.org/cvd/CHW.html. Accessed September 2, 2015.
- 28.Sabaté, E. Adherence to long-term therapies: evidence for action. World Health Organization. Geneva, Switzerland, 2003.Google Scholar
- 29.Rosenthal EL, Wiggins N, Brownstein JN, et al. The Final Report of the National Community Health Advisor Study: Weaving the Future. University of Arizona. Available online at http://www.chw-nec.org/pdf/CAHsummaryALL.pdf. Accessed September 22, 2015.
- 32.Katon W, Lundman RC, VonKorff M, et al. A randomized trial of relapse prevention of depression in primary care. Archive of General Psychiatry 2001;2001(58):3.Google Scholar
- 38.Wunderink L, Nieboer RM, Wiersma D, et al. Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry 2013;70(9):913–920.CrossRefPubMedGoogle Scholar