Journal of Developing Drugs
Open Access
ISSN: 2329-6631
+44 1478 350008
ISSN: 2329-6631
+44 1478 350008
Philip Timms
Kings College London, UK
Scientific Tracks Abstracts: J Dev Drugs
As psychiatrists, we can get very excited about the possibilities of drug therapies, especially now that genetic profiling is just beginning to give us a glimpse of a world of more personalized prescribing for individual patients. However, in the UK, in spite of trainees receiving considerable supervision and training in psychotherapies, little attention has been paid to the conversational skills that might be needed to prescribe safely and effectively. And non-adherence to prescribed medicines (and other interventions) plagues every area of medicine, not just psychiatry. In the present state of our practice, patients often have to experience inadequate response to medication and unwanted effects from it. Even if a satisfactory medication is found, the patient often has to be supported through unrewarding periods of adherence. For example, periods of tailing off medication, starting medication or optimizing doseage. A central task for these periods is the support of the patient �?? an essentially psychological task for which, in author�??s view, the prescriber needs to take responsibility. The author will review the evidence around ways of enhancing adherence and shared decision making with particular reference to a trial of adherence therapy carried out at the Maudsley hospital 20 years or so ago. Also a model for synthesizing a range of psychological skills for use in the consultation which can form a basis for investigation, training and for practice is proposed.
Philip Timms received training in Medicine and Psychiatry from Guy's Hospital, London, UK. In 1986 he helped establish the first psychiatric outreach team for homeless people in the UK and worked for 25 years as Consultant Psychiatrist for the START (Short Term Assessment and Review Team) team, an outreach for homeless people in South London. He is the Chair of the Public Engagement Editorial Group at the Royal College of Psychiatrists and designed and ran a training programme for adherence therapy at Maudsley Hospital, UK.
E-mail: philip.timms@slam.nhs.uk