BUFFALO, N.Y. -- For veterans who have returned from conflicts
overseas, fighting mental illness once home can be overwhelming.
Often there are multiple medications prescribed for specific times
throughout the day and adding to that are the medications that must
be taken for chronic physical problems.
A new study from the University at Buffalo School of Nursing
suggests that veterans who have long-term mental illness could
achieve better health outcomes if they are offered a flexible,
tailored approach to self management of their medications and
The researchers call this approach the Recovery Resource System,
which they describe in the current issue of the Archives of
"This system focuses on behaviors and strategies to encourage
active participation of the patient in his own care; it can result
in better self-management overall," says Deborah S. Finnell, DNS,
RN, UB assistant professor of nursing and primary investigator of
Finell's study is unique because while various systems have been
developed by researchers for patients, no studies have been
identified in which they were developed with patients.
"As a nurse practitioner, I have learned a lot from my
patients," says Finnell. "For example, if I prescribed a medication
that should be taken several times a day, I want to hear from the
patient about his or her daily activity. Together, we can discuss
the optimal times for their medications rather than having me
dictate the administration schedule. This collaborative approach is
more likely to result in taking the medication as intended."
The study interviewed outpatient veterans who were on long-term
mental health medications about what kinds of tools would help keep
them on track to take their medications as prescribed and which
would be easy for them to use. The study had two phases: the
development of the system using comments from 19 veterans in focus
groups, and then feedback on the Recovery Resource System from 15
veterans in focus groups.
According to the findings, veterans wanted the Recovery Resource
System to be: flexible, able to be tailored to individual needs;
dynamic or able to change in response to a new program; adaptable
or able to be modified for use in different situations;
user-friendly, not complicated; and able to address overall health
needs, which would allow for information about diet, diagnosis and
clinician to be listed.
From the interviews with veterans, Finnell and her colleagues
were able to assemble five factors that would influence the content
of the Recovery Resource System. These factors are self-management,
patient participation, shared decision-making, personal health care
and provider skills.
Finnell notes, "We approached the veterans in this study as
experts -- and they are. Their day-to-day experiences in managing
their health effectively and, at times, not so effectively, were
essential in the development of the Recovery Resource System. The
system's information, worksheets and other materials could be
useful for anyone who wants to take an active role in
self-management of health. The material clearly is designed to
foster collaboration between the patient, the family and his or her
health care providers."
Finnell would like health care providers using this resource to
be aware of the relatively short period of time they have to
influence patients and to "urge patients to be smart managers of
their health by asking questions about their response to
medications and other treatments."
The next step in the research will be to disseminate and
evaluate the Recovery Resource System, which will include measures
for each of the five components of the patient-centered
The University at Buffalo is a premier research-intensive
public university, a flagship institution in the State University
of New York system that is its largest and most comprehensive
campus. UB's more than 28,000 students pursue their academic
interests through more than 300 undergraduate, graduate and
professional degree programs. Founded in 1846, the University at
Buffalo is a member of the Association of American Universities.
The School of Nursing is one of five schools that constitute UB's
Academic Health Center.