User:Nad lim/Medication phobia

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Medication phobia, also known as pharmacophobia, is a fear of the use of pharmacological treatments. In severe, excessive and irrational cases it may be a type of specific phobia.

While lack of awareness by patient or doctor of adverse drug reactions can have serious consequences, having a phobia of medications can also have serious detrimental effects on patient health, for example refusal of necessary pharmacological interventions and problems with medication adherence. Medication phobia can also present in parents who are concerned about giving medications to their children, fearing that the medications will do more harm than good.

Adherence measurements

In order to find way to improve medication adherence due to medication phobia ways of measuring adherence must be identified. Various measures have been identified as measurements of medication adherence. Objective measures include bioassays, electronic monitoring, pharmacy refill data, and pill counting/canister weight. Subjective measures include interviews, diary/self-monitoring, and questionnaires.

Predictors

Study have shown that there are various predictors of medication phobia. Sociodemographic data such as gender, age, and education, as well as certain characteristics such as fear of liquid drug forms, fear of solid drug forms, alternative medical habits, belief in conspiracy theories, disgust toward injects and blood, belief about medicine, and anxiety are all consider possible predictors of medication phobia. Medication phobia can also be triggered by unpleasant adverse reactions to medications which are sometimes prescribed inappropriately or at excessive doses. Lack of awareness of the patient's predisposition to adverse effects (e.g. anxious patients and the elderly) and failure to attribute the adverse effects to the drug serves to compound the phobia. Fears of medication use is also prevalent in people who have experienced unpleasant withdrawal effects from psychotropic drugs. Sometimes patients wrongly associate symptoms of an acute disease or illness with medications used to treat the disease or illness.

Treatments/Improving Medication Adherence

Interventions for medication adherence for patients with medication phobia include educational, behavioral, and organizational treatment regimens. Starting at low doses and slowly increasing the medication dosage can avoid medication phobia secondary to adverse effects from developing. For pharmacophobia due to patients wrongly associating symptoms of an illness with a medication given to treat the illness, attempting to convince the patient that the symptoms were not due to the drug but due to the illness the drug was taken to treat can be done by having the patient to take test doses of the drug or another drug in the same drug class.

References

Petelinšek A, Lauri Korajlija A. Predictors of pharmacophobia. Health Psychol Res. 2020 May 26;8(1):8853. doi: 10.4081/hpr.2020.8853. PMID: 32529093; PMCID: PMC7270631.
American Psychological Association. (2014). Practice-Based Approach to Assessing and Treating Nonadherence in Pediatric Regimens. Clinical Practice in Pediatric Psychology, Volume(2), p. 322-336. Retrieved from https://www.apa.org/pubs/journals/features/cpp-0000066.pdf
Kini V, Ho PM. Interventions to Improve Medication Adherence: A Review. JAMA. 2018;320(23):2461–2473. doi:10.1001/jama.2018.19271 https://jamanetwork.com/journals/jama/fullarticle/2718800
"Anticholinergic Medication Use and Risk of Dementia among Elderly Nursing Home Residents with Depression", Authors: Noll Campbell, PharmD, MS; Joseph T. Hanlon, PharmD, MS; Subashan Perri, PharmD; Richard N. Boustani, MD, MPH; Malaz A. Boustani, MD, MPH; Anthony J. Schubert, PhD; Christopher M. Thorpe, PharmD, MS; Michael D. Slack, PhD; Amie Frame, MPH; Steven M. Bass, PhD. Clinical Medicine & Research, Volume(1), Issue(2), p. 54-65, published April 2013 http://www.clinmedres.org/content/11/2/54.short
Vicki S. Conn, Adam R. Hafdahl, Pamela S. Cooper, Todd M. Ruppar, David R. Mehr, Cynthia L. Russell, Interventions to Improve Medication Adherence Among Older Adults: Meta-Analysis of Adherence Outcomes Among Randomized Controlled Trials, The Gerontologist, Volume 49, Issue 4, August 2009, Pages 447–462, https://doi.org/10.1093/geront/gnp037
Park L.G., Howie-Esquivel J. & Dracup K. (2014) A quantitative systematic review of the efficacy of mobile phone interventions to improve medication adherence. Journal of Advanced Nursing 70(9), 1932–1953. https://onlinelibrary.wiley.com/doi/full/10.1111/jan.12400
Lucca JM, Joseph R, Al-Sunbul Z, Althawab L. Impact of Pharmacophobia and Pharmacophilia on Perception of Medication Use and Self-Medication Behaviors in Saudi Arabia. Psychopharmacol Bull. 2022 Oct 27;52(4):85-99. PMID: 36339273; PMCID: PMC9611794.
De Las Cuevas C, Motuca M, Baptista T, de Leon J. Skepticism and pharmacophobia toward medication may negatively impact adherence to psychiatric medications: a comparison among outpatient samples recruited in Spain, Argentina, and Venezuela. Patient Prefer Adherence. 2018 Feb 20;12:301-310. doi: 10.2147/PPA.S158443. PMID: 29503532; PMCID: PMC5824753.
De Las Cuevas C, Peñate W. Explaining pharmacophobia and pharmacophilia in psychiatric patients: relationship with treatment adherence. Hum Psychopharmacol. 2015 Sep;30(5):377-83. doi: 10.1002/hup.2487. Epub 2015 May 25. PMID: 26010762.