Breakthrough in psychiatric care. Pharmacological treatment of obsessive-compulsive disorders with implications for nursing care.
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Antidepressive Agents↗
Biomedical subjects
S B Malone
Publications and source records attributed to S B Malone.
Improving treatment adherence in drug abusers who are HIV-positive.
This article discusses the complex dual diagnosis of HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) and substance abuse, which affects a growing number of individuals worldwide. A brief review of HIV/AIDS is provided and the connection between HIV/AIDS and substance abuse is described. Substance abuse complicates both HIV/AIDS and its management because of the effects that illicit drugs have on various body systems and because of the behavioral disturbances that accompany substance use. For a variety of reasons adherence to treatment is poor in this population and several factors that negatively impact adherence are outlined. Treatment of drug abusers who are HIV-positive requires more flexibility than treating drug abuse and HIV separately. Because medication regimens can be complicated and demanding and nonadherence to treatment can cause mutation of the virus resulting in drug-resistant strains, it is essential to get the patient committed to treatment The goals of treatment are abstinence from illicit drugs, adherence to a treatment regimen, suppression of viral load, improved CD4 count, and improved quality of life. The role of the case manager is critical to improving treatment adherence. Essential attributes include knowledge of disease processes, critical thinking, and the ability to navigate the healthcare system. Case management interventions to improve treatment adherence should be directed at the patient, the regimen, the client-patient relationship, and the healthcare system. Because HIV/AIDS is now classified as a chronic disease and is no longer viewed as a death sentence, people who are HIV-positive have hope for longevity and a cure. It is this hope for a longer life and possible cure that can be used to motivate substance abusers who are HIV-infected to improve their treatment adherence and quality of life.
Antiretroviral Therapy, Highly Active↗
Team case management of chronically mentally ill veterans: a group therapy approach.
This article describes a team case management model using a group therapy approach developed and implemented for chronically mentally ill veterans. The model was developed to address inadequacies in the system and to provide mentally ill veterans with more frequent interventions and an organized support system to maintain them in the community. Two hundred seventy-five patients enrolled in the case management system attend weekly groups led by two or three interdisciplinary staff. In addition to serving as primary therapists and case managers, the interdisciplinary staff broker services, linking patients with needed services within the Veterans Affairs system and the community. The results indicate that the case management model has improved the lives of those enrolled by improving quality of life, medication and treatment compliance, social relationships, and general well-being. Use of emergency room services has decreased, as well as psychiatric symptomatology. For some diagnostic categories, the number of hospital readmissions and days hospitalized also decreased.
Case Management↗