[Why do patients find it difficult to discontinue their medication?]
SourceNederlands Tijdschrift voor Geneeskunde, 165, (2021), article D6054
Article / Letter to editor
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Primary and Community Care
Nederlands Tijdschrift voor Geneeskunde
SubjectRadboudumc 13: Stress-related disorders DCMN: Donders Center for Medical Neuroscience; Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences
Tapering medication is difficult for many patients using chronic medication. Physicians must be aware of why patients experience difficulties in discontinuation. Important are the cognitions of patients about why the medication is necessary, for example because of the deficit of a certain substance that is supplemented by the medication. Or a too favourable expectation of the effect while time-to-benefit has passed. The experience of withdrawal effects during earlier attempts or the experience of dependency hamper new attempts to stop. This is important in medication that induces physical dependency: antipsychotics, antidepressants, benzodiazepines, or proton pump inhibitors. Fear for relapse is also hampering discontinuation; this is at stake in patients with psychosis, depression and epilepsy. Finally, poor communication and not having a trusted professional are impediments for discontinuation. To be successful in helping patients discontinue their medication professionals must communicate well about the patient's personal attitude, experience, emotions, and life circumstances as well as to possess expertise about the technical aspects of the procedure of stopping medication.
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