Prevalence and predictors of sub-optimal medication adherence among patients with severe mental illnesses in a tertiary psychiatric facility in Maiduguri, North-eastern Nigeria
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INTRODUCTION: Sub-optimal adherence constitutes a significant impediment to the management of severe mental illnesses (SMIs) as it negatively impacts on the course of the illness and the treatment outcome. In this study, the levels of adherence, prevalence and the predictors of sub-optimal adherence were assessed in a sub-Saharan African setting. METHODS: Three hundred and seventy (370) respondents with diagnoses of schizophrenia, bipolar disorder or severe depression were randomly enrolled and interviewed at the out-patient department of the Federal Neuropsychiatric Hospital, Maiduguri in northeastern Nigeria. An anonymous sociodemographic questionnaire and a clinical proforma designed by the authors, Oslo social support scale and the 8-item Morisky Medication Adherence Scale (MMAS-8) were used for data collection. RESULTS: The prevalence of sub-optimal adherence was 55.7%. The independent predictors of sub-optimal adherence were; seeking for traditional/ spiritual treatment (Odds Ratio (O.R.) = 6.523, 95% C.I. = 3.773 - 11.279, P = < 0.001), male gender (O.R. = 3.307, 95% C.I. = 1.907 - 5.737, P = < 0.001), low levels of insight (O.R. = 1.753, 95 C.I. = 1.220 - 2.519, P = 0.002), and low social support levels (O.R. = 1.528, 95% C.I. = 1.097 - 2.129, P = 0.012). CONCLUSION: Based on the outcome of the study, we recommend the development of psycho-educational programmes on adherence and the active involvement of the relations and significant others in the management of patients with SMIs in sub-Saharan Africa.
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Being male was linked with medication non-adherence in two studies.
“but in two studies, being male also linked with medication non-adherence [21, 54].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [21]
Patients having negative attitudes toward psychotropic medication were more likely to seek alternative treatment such as traditional or religious treatment practices in two studies.
“Moreover, in two studies, patients having negative attitudes toward the psychotropic medication were more likely to seek alternative treatment such as traditional or religious treatment practices [21, 24].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [21]
Patients' lack of insight about their illness and medication was a common factor associated with psychotropic medication non-adherence in seven studies.
“In seven studies, patients’ lack of insight (level of awareness or understanding) about their illness and medication was a common factor associated with psychotropic medication non-adherence [21, 23, 28, 39, 40, 50, 51].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [21]
Poor or lack of social or family support was associated with psychotropic medication non-adherence in seven studies.
“In seven studies, poor or lack of social or family support was associated with psychotropic medication non-adherence [21, 24, 25, 35, 37, 45, 65].”
From Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis (2020) · cites this paper as [21]
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“Previous authors in Nigeria have used the tool, as well as similar dichotomy/cut off score.(31)”
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“However, our observed non-adherence rate is lower than reported in studies from Nigeria (44.3% ) 11 , Saudi Arabia (52.9% ) 30 , India (66.9% ) 31 , Japan (63.1% ) 32 , Thailand (59% ) 33 and Ethiopia (38.7-50.48”
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“These conditions are characterized by a significant and ongoing impacts on individual’s cognitive, emotional, and social functioning, leading to a corresponding impairment in daily activities [3, 4].”
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“11,12 In this study, 33.3%of the respondents were employed and 66.7% were unemployed whereas employment status was significantly associated with the factors for psychotropic medication non-adherence and it was in line with 2 more studies.”
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“W .”
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“9,40,41 Treatment buddy support improved adherence (86.1 % ) in our study and could thus benefit patients in similar settings.”
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“44 Medication attitude inventory (DAI) tool.”
Bakay, H., & Şahin, M. F. (2025) · Çukurova medical journal (Online)/Çukurova medical journal · doi:10.17826/cumj.1795623
Mapping medication adherence tools in Africa: a scoping review
Muchanga, I. J., Midão, L., Mazuze, A. N., Melo, D., Alcântara, L., Figueiredo, T., Costa, E., & Sousa‐Pinto, B. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-112898
- Authors
- Ibrahim, A. W., Yahya, S., Pindar, S. K., Wakil, M. A., Garkuwa, A., & Sale, S.
- Affiliations
- University of Maiduguri (NG)
- Abubakar Tafawa Balewa University (NG)
- Bayero University Kano (NG)
- Corresponding author
- Ibrahim, Abdu Wakawa
- Venue
- Pan African Medical Journal
- Publisher
- Pan African Medical Journal
- Published
- 2015
- Volume
- 21
- Pages
- 39-39
- ISSN
- 1937-8688 (ISSN-L)
- PMC
- PMC4564429
- OpenAlex
- W222492916
- Cited by
- 43
- References
- 48
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 9 · 2023: 6 · 2022: 5 · 2021: 3 · 2020: 1 · 2019: 5 · 2018: 1 · 2017: 2 · 2016: 1
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Pan African Medical Journal (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- medication adherence, severe mental illness, schizophrenia, bipolar disorder, severe depression, predictors of non-adherence, social support, insight, gender differences, psycho-educational program, Maiduguri
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Cross-Sectional Studies, Depressive Disorder, Female, Hospitals, Psychiatric, Humans, Male, Middle Aged, Nigeria, Surveys and Questionnaires, Schizophrenia, Severity of Illness Index, Prevalence, Drug Monitoring, Young Adult
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