Journal of Psychosomatic Research
Volume 68, Issue 3 , Pages 303-309, March 2010

Can we increase adherence to treatment recommendations of the consultation psychiatrist working in a general hospital? A systematic review

  • Albert F.G. Leentjens

      Affiliations

    • Maastricht University Medical Center, Maastricht, The Netherlands
    • Corresponding Author InformationCorresponding author. Department of Psychiatry, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Tel.: +31 43 3877443; fax: +31 43 3875444.
    • ,
  • Annette D. Boenink

      Affiliations

    • Vrije Universiteit Medical Center (VUMC), Amsterdam, The Netherlands
    • ,
  • Christina M. van der Feltz-Cornelis

      Affiliations

    • Vrije Universiteit Medical Center (VUMC), Amsterdam, The Netherlands
    • Trimbos Institute for Health Care Research, Utrecht, The Netherlands

Received 25 May 2009; received in revised form 7 July 2009; accepted 9 July 2009. published online 20 November 2009.

Abstract 

Background

Adherence to advice given by the consultation–liaison (CL) psychiatrist is a prerequisite for the effectiveness and success of psychiatric consultation. It is unknown which factors are associated with better adherence to advice.

Aim

To review the adherence of consultees with advice given by the psychiatrist during inpatient consultation.

Method

Systematic literature review.

Results

Eighteen studies reported on the level of adherence with recommendations given by the consultation psychiatrist in a hospital setting. All were retrospective cohort studies conducted before 1998. Thirteen of these reported on the association between clinical variables and the level of adherence.

The median level of adherence with diagnostic advice was 56% (range 29–75%), with medication advice 79% (range 68–98%), and with discharge advice 91% (range 85–95%). Patient-related variables were not associated with adherence, nor were consultee-related variables. Consultant-related variables associated with adherence were level of professional expertise, organizing liaison activities, following up on patients after initial consultation, and prescription of medication by the consultant during the consultation.

Conclusion

This review provides evidence for a role of consultant characteristics and an active approach of the consultant in terms of CL activities as well as consultation procedures, in attaining adherence to advice. Prospective qualitative research is needed to identify consultation methods that may further enhance adherence.

Keywords: Consultation psychiatry, Liaison psychiatry, Adherence, Concordance

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PII: S0022-3999(09)00271-2

doi:10.1016/j.jpsychores.2009.07.006

Journal of Psychosomatic Research
Volume 68, Issue 3 , Pages 303-309, March 2010

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