Prevalence of Medication Non-adherence and Associated Factors Among Psychotic Patients in Dessie Referral Hospital, Amhara Region, North East Ethiopia, 2019
American Journal of Psychiatry and Neuroscience
Volume 8, Issue 4, December 2020, Pages: 87-99
Received: Sep. 30, 2020;
Accepted: Oct. 21, 2020;
Published: Nov. 27, 2020
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Asmare Belete, Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
Yalew Mebrie, Psychiatry Unit, Dessie Referral Hospital, Dessie, Ethiopia
Mengesha Birike, Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
Mogesie Necho, Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
Introduction: Psychotic disorders are severe, impairing and typically a chronic mental disorders and the clinical presentations of psychotic symptoms are diverse and affect a person’s thoughts and actions. Therefore, it is psychiatric disorder significantly contribute to the burden of diseases worldwide. Then, non-adherence is a major problem among Psychotic patients. Objective: To assess the prevalence of medication non adherence and associated factors among psychotic patients in psychiatric outpatient department in Dessie Referral Hospital 2019. Methods and materials: A hospitalized based cross sectional study was conducted from October 1/2018 to January 10/2019. The final sample consisted of 395 psychotic patients with on medication were selected by systematic random sampling technique. Morsiky medication adherence rating scale, Birchwood insight scale and oslow social support rating scale were used for data collected. Data was entered, cleaned and stored in EPI info version 3.1 and exported into SPSS version 21 for further analysis. Result: The response rate of the study was 93.6%%. A total of 199 (50.4%) females were participated in this study. The mean age of participants was 37 (SD±14 years) and age ranged from 18 to 88 year. The overall prevalence of medication non -adherence was found to be 44.3%. The factors such as being widowed (AOR=0.324, 95% CI, (0.135-.779), being daily labor (AOR=.344, 95% CI, (.124-.957) and have been suicidal ideation (AOR=0.322, 95% CI, (0.140-0.740) were negatively associated. Whereas being unable to read and write (AOR=2.611, 95% CI, (1.076-6.333) and length of the medication < 6 months (AOR=2.069, 95% CI, (1.127-3.799) were found to be positively associated with medication non-adherence. Conclusion and Recommendation: The result of this study showed that non adherence among psychotic patients was found to be high and indicted independent associated factors. And this finding has significant implications to enhance level of non-adherence by tackling determinant factors (above mentioned in result) and critical intervention program required and further research should be needed.
Prevalence of Medication Non-adherence and Associated Factors Among Psychotic Patients in Dessie Referral Hospital, Amhara Region, North East Ethiopia, 2019, American Journal of Psychiatry and Neuroscience.
Vol. 8, No. 4,
2020, pp. 87-99.
Organization WH. Global status report on noncommunicable diseases 2014: World Health Organization; 2014.
Lopez AD, Murray CC. The global burden of disease, 1990–2020. Nature medicine. 1998; 4 (11): 1241-3.
Ghulam R, Prakash O. Block-1 Mental Health in Special Population. IGNOU; 2017.
Misganaw A, Haregu TN, Deribe K, Tessema GA, Deribew A, Melaku YA, et al. National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990–2015: findings from the Global Burden of Disease Study 2015. Population health metrics. 2017; 15 (1): 29.
Organization WH. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization, 2003. Google Scholar. 2019.
Sabate E. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003. Google Scholar. 2016.
Murray CJ, Lopez AD, Jamison DT. The global burden of disease in 1990: summary results, sensitivity analysis and future directions. Bulletin of the World Health Organization. 1994; 72 (3): 495.
Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiologia e psichiatria sociale. 2009; 18 (1): 23.
Ayenalem AE, Tiruye TY, Muhammed MS. Impact of self stigma on quality of life of people with mental illness at dilla university referral hospital, South Ethiopia. American Journal of Health Research. 2017; 5 (5): 125-30.
Laugharne R, Priebe S, McCabe R, Garland N, Clifford D. Trust, choice and power in mental health care: Experiences of patients with psychosis. International Journal of Social Psychiatry. 2012; 58 (5): 496-504.
Kaplan BJ. Kaplan and sadock’s synopsis of psychiatry. Behavioral sciences/clinical psychiatry. Tijdschrift voor Psychiatrie. 2016; 58 (1): 78-9.
Smith L, Nathan P, Juniper U, Kingsep P, Lim L. Cognitive Behavioral Therapy for Psychotic Symptoms: A Therapist’s Manual. Centre for Clinical Interventions: Perth, Australia; 2003. ISBN I-876763-23-x.
Jónsdóttir H. Adherence to pharmacological treatment in patients with severe mental disorders. 2012.
Reed SI. First-episode psychosis: A literature review. International journal of mental health nursing. 2008; 17 (2): 85-91.
Albers LJ, Hahn RK, Reist C. Handbook of psychiatric drugs: Current Clinical Strategies Pub.; 2005.
Food E. Medicine and Healthcare Administration and Control Authority. Continuing Professional Development (CPD) Guideline for Health Professionals in Ethiopia Addis Ababa: FMoH. 2013.
Nosé M, Barbui C, Gray R, Tansella M. Clinical interventions for treatment non-adherence in psychosis: meta-analysis. The British Journal of Psychiatry. 2003; 183 (3): 197-206.
Gray R, Lathlean J, Mills A, Bressington D, Veenhuyzen W. Observational cross sectional pilot study of adherence with antipsychotic medication in people with schizophrenia or schizoaffective disorders in prisons. Report to the NHS National R and D programme on forensic mental health. 2007: 1-87.
Tareke M, Tesfaye S, Amare D, Belete T, Abate A. Antipsychotic medication non-adherence among schizophrenia patients in Central Ethiopia. South African Journal of Psychiatry. 2018; 24.
Ala-Nikkola T, Pirkola S, Kontio R, Joffe G, Pankakoski M, Malin M, et al. Size matters—determinants of modern, community-oriented mental health services. International Journal of Environmental Research and Public Health. 2014; 11 (8): 8456-74.
Girma S, Abdisa E, Fikadu T. Prevalence of Antipsychotic Drug Non Adherence and Associated Factors Among Patients with Schizophrenia Attending at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: Institutional Based Cross Sectional Study. Health Science Journal. 2017; 11 (4).
Eticha T, Teklu A, Ali D, Solomon G, Alemayehu A. Factors associated with medication adherence among patients with schizophrenia in Mekelle, Northern Ethiopia. PLoS One. 2015; 10 (3): e0120560.
Mamo ES, Gelaw BK, Tegegne GT, Alemu TN, Legese K. Medication Adherence among Patients with Schizophrenia Treated With Antipsychotics at Adama Hospital, East Shoa Zone, Oromia Regional State. Adv Pharmacoepidemiol Drug Saf. 2016; 5 (200): 2167-1052.1000200.
Zenebe Y, Feyissa G, Krahl W. Khat use in persons with mental illness in Southwest Ethiopia: a cross-sectional study. 2015.
Berger A, Edelsberg J, Sanders KN, Alvir JMJ, Mychaskiw MA, Oster G. Medication adherence and utilization in patients with schizophrenia or bipolar disorder receiving aripiprazole, quetiapine, or ziprasidone at hospital discharge: a retrospective cohort study. BMC psychiatry. 2012; 12 (1): 99.
King D. Non-adherence to medication in schizophrenia: The impact on service use and costs: The London School of Economics and Political Science (LSE); 2010.
Alene M, Wiese MD, Angamo MT, Bajorek BV, Yesuf EA, Wabe NT. Adherence to medication for the treatment of psychosis: rates and risk factors in an Ethiopian population. BMC Clinical Pharmacology. 2012; 12 (1): 10.
Adams SG, Howe JT. Predicting medication compliance in a psychotic population. Journal of Nervous and Mental Disease. 1993.
Danzer G, Rieger SM. Improving medication adherence for severely mentally ill adults by decreasing coercion and increasing cooperation. Bulletin of the Menninger Clinic. 2016; 80 (1): 30-48.
CSA-Ethiopia I. International: Ethiopia Demographic and Health Survey 2011. Central Statistical Agency of Ethiopia and ICF International Addis Ababa, Ethiopia and Calverton, Maryland, USA. 2012.
Chatterjee S, Naik S, John S, Dabholkar H, Balaji M, Koschorke M, et al. Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): a randomised controlled trial. The Lancet. 2014; 383 (9926): 1385-94.
Higashi K, Medic G, Littlewood KJ, Diez T, Granström O, De Hert M. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review. Therapeutic advances in psychopharmacology. 2013; 3 (4): 200-18.
Amr M, El-Mogy A, El-Masry R. Adherence in Egyptian Patients with Schizophrenia: The Role of Insight, Medication Beliefs and Spirituality The Arab Journal of Psychiatry. 2013; 44 (473): 1-18.
Ibrahim A, Pindar S, Yerima M, Rabbebe I, Shehu S, Garkuwa H, et al. Medication-related factors of non-adherence among patients with schizophrenia and bipolar disorder: outcome of a cross-sectional survey in Maiduguri, North-eastern Nigeria. J Neurosci Behav Health. 2015; 7 (5): 31-9.
Baskaran M, Jayasudha A, Thomas SE, Francis S. Role play on drugs non-compliance among caretakers of mentally Ill clients in tertiary hospitals, Coimbatore.
Andersson Sundell K, Jönsson AK. Beliefs about medicines are strongly associated with medicine-use patterns among the general population. International journal of clinical practice. 2016; 70 (3): 277-85.
Buchanan A. A two-year prospective study of treatment compliance in patients with schizophrenia. Psychological medicine. 1992; 22 (3): 787-97.
Baylé FJ, Tessier A, Bouju S, Misdrahi D. Medication adherence in patients with psychotic disorders: an observational survey involving patients before they switch to long-acting injectable risperidone. Patient preference and adherence. 2015; 9: 1333.
Malik K. Human development report 2014: Sustaining human progress: Reducing vulnerabilities and building resilience: United Nations Development Programme, New York; 2014. Kazadi N, Moosa M, Jeenah F. Factors associated with relapse in schizophrenia. South African Journal of Psychiatry. 2008; 14 (2): 52-62.
Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. The Journal of Clinical Hypertension. 2008; 10 (5): 348-54.
Hogan TP, Awad A, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychological medicine. 1983; 13 (1): 177-83.
Procidano ME, Heller K. Measures of perceived social support from friends and from family: Three validation studies. American journal of community psychology. 1983; 11 (1): 1-24.
Wahab IA, Pratt N, Kalisch L, Roughead E. Sequence symmetry analysis and disproportionality analyses: what percentage of adverse drug reaction do they signal?: OMICS Publishing Group; 2013.