|School of Nursing|
Not taking prescribed medications is a major problem for patients with schizophrenia, who may not be aware of the symptoms the drugs are designed to treat. According to Dr. Yoriko Kozuki, psychiatric nurse practitioner and nurse researcher, such “non-adherence” creates a significant public health problem, especially when patients are homeless or living without social support. But with a new nursing intervention Kozuki is testing, the problem of non-adherence may soon be reduced.
With grant funding received as a Pfizer postdoctoral fellow, Kozuki, an assistant professor at the UW School of Nursing, will be testing the efficiency of a device called a “smart cap” to increase medication adherence. “Smart caps” are tall domed lids that fit most standard prescription bottles. They contain a tiny computer chip that shows the patient when it is time for his or her dose. They also record the time and date when the bottle is opened. This information can then be transferred to the practitioner’s computer, where it becomes part of a graph for each patient.
“Taking medication erratically is just as ineffective as not taking it at all,” explains Kozuki. “With the ‘smart cap,’ practitioners will be able to see why a patient’s symptoms may be worsening even though they are taking their drugs.”
Dr. Karen Schepp from the UW School of Nursing, Kozuki’s mentor, agrees. “The essence of treatment for those with schizophrenia is medication adherence. Yoriko’s work is of utmost importance in increasing the behaviors that will lead to this goal.” Schepp is principal investigator on a successful long-term study for youth with schizophrenia that helps them learn self-management techniques.
Using medications correctly also helps practitioners determine the best pharmaceutical agent for each patient. Kozuki notes that this is of “tremendous value” in improving quality of life. “As nurses, we are concerned with treating the whole person, not just the symptoms,” she adds. “By reducing symptoms of schizophrenia, such as paranoia and delusions, we can provide more effective counseling and support.”
During pilot studies funded by the VanHooser Endowed Research Fund in the School of Nursing, Kozuki and her research team worked with an ethnically diverse population of about 1,000 patients who come to the mental health clinic at Harborview Medical Center. She notes that the ‘smart caps’ with their simple numerical “cues” are doubly valuable for patients who struggle with English directions. The new study will work with the same population and will continue for another two years.
Only two Pfizer Postdoctoral Fellowships in Nursing Research are awarded annually. Kozuki, who joined the faculty a year ago, is the first researcher in the nursing school to receive one.