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SWAM Scale
The SWAM Scale: An Instrument to Assess Satisfaction With Antipsychotic Medication
Diana Rofail, MSc
Health Psychologist & Senior Project Manager, Questionnaire Development and Validation Unit, Mapi Values, Adelphi Mill, Bollington, SK10 5JB, United Kingdom. 

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Keywords: patient satisfaction; antipsychotic agents; questionnaire.

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Antipsychotic medications counterbalance the symptoms experienced by patients with psychotic disorders such as schizophrenia1. Despite this, some patients still experience the symptoms of their condition such as auditory and visual hallucinations2, and often antipsychotic medications are associated with unwanted side effects such as weight gain, sexual dysfunction, and anticholinergic effects3,4. Further, patients may experience extrapyramidal symptoms such as pseudoparkinsonism, dystonia, akinesia, and tardive dyskinesia5. Having acknowledged this, it is perhaps not surprising that some patients find their medication undesirable, with approximately 50% failing to take their medication as recommended by their doctor6-8. Non-adherence to medication regimens may result in an increased likelihood of relapse9,10 and severity of relapse episodes11. Consequently, re-admission rates increase, which in turn may affect expenditure on healthcare12. Non-adherence also incurs social costs such as substance misuse, homelessness, and burden on carers11. Given the above, it is evident that schizophrenia and its medication can be burdensome to patients, caregivers, and society. With recent health policies and communications emphasising the need to assess and improve patients’ subjective experiences regarding the quality and care of services received13-16, and an increasing awareness that people with mental conditions are able to reliably and validly report their experiences17,18, the SWAM scale may be useful for healthcare professionals responsible for managing the treatment of patients with schizophrenia, or as an assessment of antipsychotic agents from the patients perspective. The instrument was originally developed based on published research, clinical expert’s and service user’s opinions, as well as input from 315 patient’s with schizophrenia in the UK19. It quantifies patient satisfaction with antipsychotic medication based on an operational definition of what constitutes patient satisfaction, as well as a conceptual framework which makes sense of the complex set of factors associated with the concept.


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