Adherence to medication for the treatment of psychosis: rates and risk factors in an Ethiopian population
Open accessAbstract
Background: Medication-taking behavior, specifically non-adherence, is significantly associated with treatment outcome and is a major cause of relapse in the treatment of psychotic disorders. Non-adherence can be multifactorial; however, the rates and associated risk factors in an Ethiopian population have not yet been elucidated. The principal aim of this study was to evaluate adherence rates to antipsychotic medications, and secondarily to identify potential factors associated with non-adherence, among psychotic patients at tertiary care teaching hospital in Southwest Ethiopia. Methods: A cross-sectional study was conducted over a 2-month period in 2009 (January 15 th to March 20 th) at the Jimma University Specialized Hospital. Adherence was computed using both a compliant fill rate method and self-reporting via a structured patient interview (focusing on how often regular medication doses were missed altogether, and whether they missed taking their doses on time). Data were analyzed using SPSS for windows version 16.0, and chi-square and Pearsons r tests were used to determine the statistical significance of the association of variables with adherence. Result: Three hundred thirty six patients were included in the study. A total of 75.6% were diagnosed with schizophrenia, while the others were diagnosed with other psychotic disorders. Most (88.1%) patients were taking only antipsychotics, while the remainder took more than one medication. Based upon the compliant fill rate, 57.5% of prescription fills were considered compliant, but only 19.6% of participants had compliant fills for all of their prescriptions. In contrast, on the basis of patients self-report, 52.1% of patients reported that they had never missed a medication dose, 32.0%sometimes missed their daily doses, 22.0% only missed taking their dose at the specific scheduled time, and 5.9% missed both taking their dose at the specific scheduled time and sometimes missed their daily doses. The most common reasons provided for missing medication doses were: forgetfulness (36.2%); being busy (21.0%); and a lack of sufficient information about the medication (10.0%). Pill burden, medication side-effects, social drug use, and duration of maintenance therapy each had a statistically significant association with medication adherence (P ≤ 0.05). Conclusion: The observed rate of antipsychotic medication adherence in this study was low, and depending upon the definition used to determine adherence, it is either consistent or low compared to previous reports, which highlights its pervasive and problematic nature. Adherence must therefore be considered when planning treatment strategies with antipsychotic medications, particularly in countries such as Ethiopia.
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Patients and caregivers reported being busy with daily routines, careless about timing, forgetting to remember medication time, and irregular follow-up were associated with medication non-adherence in six studies.
“In six studies, patients and caregivers reported being busy with daily routines, careless about the timing, forgetting to remember medication time, and irregular follow-up were associated with medication non-adherence [11, 22, 24, 34, 35, 52].”
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 [22]
Psychotropic medication non-adherence was associated with medication-related side-effects in several studies.
“In several studies, psychotropic medication non-adherence was associated with medication-related side-effects [11, 22–25, 28–30, 32–37, 39, 44, 50, 52, 55, 64, 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 [22]
Behavioral factors such as forgetting the right dose and right time of taking medication were factors associated with medication non-adherence in seven studies.
“In seven studies, behavioral factors such as forgetting the right dose and right time of taking medication were the factors associated with medication non-adherence [11, 22, 24, 28, 34, 35, 52].”
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 [22]
Long treatment duration (6-12 months and longer) was an associated factor for medication non-adherence in five studies.
“In five studies, long treatment duration (6–12 months and longer) was an associated factor for medication non-adherence [22, 25, 37, 43, 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 [22]
Pill burden or consuming extra pills was one of treatment-related factors that negatively influenced patients' adherence to their psychotropic medication in two studies.
“In two studies, pill burden or consuming extra pills was also one of treatment-related factors that negatively influenced patients’ adherence to their psychotropic medication [22, 53].”
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 [22]
Lack of sufficient and quality health education to psychiatric patients and/or their caregivers/relatives/families about the medication and illness influenced patients' adherence to their prescribed medication.
“On the other hand, the lack of sufficient and quality health education to psychiatric patients and or their caregivers/relatives/families about the medication and illness influenced patients’ adherence to their prescribed medication [22, 36, 39, 40, 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 [22]
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- Authors
- Alene, M., Wiese, M. D., Angamo, M. T., Bajorek, B. V., Yesuf, E. A., & Wabe, N. T.
- Affiliations
- University of South Australia (AU)
- Jimma University (ET)
- University of Technology Sydney (AU)
- Corresponding author
- Wabe, Nasir Tajure
- Venue
- BMC Clinical Pharmacology
- Published
- 2012-06-18
- Volume
- 12
- Issue
- 1
- Pages
- 10-10
- ISSN
- 1472-6904 (ISSN-L)
- PMC
- PMC3416691
- OpenAlex
- W1965366053
- Cited by
- 34
- References
- 53
- Citations by year
- 2025: 5 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 3 · 2014: 3 · 2013: 2
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BMC Clinical Pharmacology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion, other-oa)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
- OPUS - Open Publications of UTS Scholars (University of Technology Sydney) (submittedVersion)
- Funders
- Jimma University
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- medication adherence, antipsychotic drugs, psychosis, schizophrenia, medication burden, adverse drug reactions, maintenance therapy duration, Ethiopian patients, self-reported adherence, forgetfulness, relapse risk, Jimma University Specialized Hospital, Southwest Ethiopia, South America
- MeSH terms
- Adolescent, Adult, Child, Cross-Sectional Studies, Ethiopia, Female, Humans, Male, Middle Aged, Psychotic Disorders, Risk Factors, Schizophrenia, Antipsychotic Agents, Medication Adherence, Young Adult, Self Report, Tertiary Health Care
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