Nicotine Withdrawal, Relapse of Mental Illness, or Medication Side-Effect? Implementing a Monitoring Tool for People With Mental Illness Into Quitline Counseling

Background. Many people with mental illness perceive and experience stigma caused by other people’s knowledge, attitudes, and behavior. The stigma can lead to patients’ impoverishment, social marginalization, poor adherence to medication, and low quality of life, worsen the disease, decrease health-seeking behavior, and have a negative impact on socioeconomic well-being. Therefore, this study aimed to explore these issues. Objective. To assess the magnitude and associated factors of perceived stigma among adults with mental illness in an Ethiopian setting. Methods. A facility-based, cross-sectional study design with a consecutive sampling technique was employed from September 1 to 30, 2012. Data for perceived stigma were assessed by using the perceived devaluation-discrimination (PDD) scale from new or returning patients. The data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20. The results were described with the frequency table, graph, mean, and standard deviation. Bivariate analysis was used to get candidate variables for multivariate logistic regression analysis. Variables with a P value of < 0.05 at multivariate analysis were considered statistically associated with perceived stigma. Results. A total of 384 participants were interviewed and the response rate was 100%. The prevalence of high and low perceived stigma was 51% and 44%, respectively. Having substance use history (AOR=0.6, 95% CI: 0.4–0.9) and family support (AOR=2.5, 95% CI: 1.5–4.3) and medication side effects (AOR=0.6, 95% CI: 0.5–0.8) were associated statistically with higher perceived stigma of people with mental illness. Conclusion. Perceived stigma is a major problem of adults with mental illness in this outpatient setting in Ethiopia. Patients who had substance use and family support and medication side effects were more likely to have high perceived stigma. Therefore, screening and management of substance use, social support, and medication side effect should be strengthened for people with mental illness.

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The False Drug Side-Effect: Which Patients Complain

The British Journal of Psychiatry ◽

10.1192/bjp.114.507.197 ◽

1968 ◽

Vol 114 (507) ◽

pp. 197-201 ◽

Cited By ~ 2

Author(s):

William S. Appleton

Keyword(s):

Mental Health ◽

Side Effects ◽

Health Center ◽

Side Effect ◽

Mental Health Center ◽

Young Female ◽

Need For Care ◽

Drug Induced ◽

Medication Side Effect ◽

Medication Side

At the Massachusetts Mental Health Center (M.M.H.C.), a well-staffed university psychiatric hospital, an outbreak of alleged chlorpromazine-induced skin rashes recently occurred involving five dramatic young female patients. Investigation of the complaints led us to doubt whether medication was the cause. Why then did these women blame chlorpromazine? Thus, the central concern of this investigation: which patients are likely to complain of drug-induced side-effects and under what conditions? A second issue arising from our study and described in the literature is the need for care when differentiating the true from the alleged medication side-effect.

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Tolerance of aromatase inhibitors in post-menopausal patients with early-stage hormone receptor positive (HR+) breast cancer: A real-world retrospective analysis in a large oncotype database.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e12532 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e12532-e12532

Author(s):

Shana Berwick ◽

Brittney Shulman Zimmerman ◽

Sara Malin Hovstadius ◽

Julia Blanter ◽

Erin Moshier ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Therapy ◽

Endocrine Therapy ◽

Aromatase Inhibitors ◽

Median Duration ◽

Side Effect ◽

Early Stage ◽

Medication Side Effect ◽

Medication Side ◽

Post Menopausal

e12532 Background: Aromatase inhibitors (AIs) compose the backbone of adjuvant endocrine therapy for early-stage HR+ breast cancer. Prior studies have demonstrated equivalence in efficacy between aromatase inhibitors in current clinical use. Thus choice of aromatase inhibitors is initially influenced by provider patterns and tailored based on adverse side effects. This study retrospectively evaluates the prevalence of intolerance to AIs warranting a change in therapy. Methods: We identified 181 post-menopausal patients with early-stage, HR+ breast cancer within a database of women who underwent oncotype testing at a large, urban medical center, with 167 (92%) receiving an AI. Patients were excluded if they had received chemotherapy. The Kaplan-Meier method was used to estimate median duration of endocrine therapy (ET). The Fisher’s exact test was used to compare proportions of patients requiring a switch in adjuvant AI and the Wilcoxon rank-sum test was used to compare age distributions. Results: Of the patients identified, 153 (90%) had stage IA disease with a median oncotype RS of 19. 167 (92%) patients received an AI as adjuvant therapy. Median duration of endocrine therapy (ET) was 83.5 months, with over 90% of patients on ET more than 5 years. Among the 152 patients with available data on ET interruptions, 52 (34%) patients had a change or interruption in their ET of these 40 (77%) were attributed to a medication side effect. The AI prescribed most frequently as initial therapy was anastrozole 138/165 (84%). 33 (24%) of patients who received anastrozole required a drug switch within the class, (no sig difference based on initial adjuvant therapy; p=0.4281). 12 (7%) patients required a switch from an AI to tamoxifen at some point during therapy. Changes in AI adjuvant therapy were most commonly attributed to joint pains 24 (46%), followed by hot flashes 2 (4%) and weight gain, 2 (4%). There was no statistically significant difference in median age between patients who interrupted ET due to medication side effect or other reason; p=0.2906. Conclusions: This study enforces previous findings that a significant proportion of women require a change in their adjuvant ET, most commonly due to adverse medication effects such as joint pain. The majority of the women in this database were initiated on anastrozole as initial adjuvant ET of whom 24% required a drug switch.[Table: see text]

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