Nigerian Journal of Clinical Practice

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Medication compliance behavior in psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian tertiary hospital

CI Okpataku, HO Kwanashie, JI Ejiofor, VO Olisah


Background: Psychotropic medication adherence is a major challenge in psychiatric patients with comorbidity.
Objective: The objective was to determine medication adherence behavior among psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian Tertiary Hospital.
Settings and Design: A cross‑sectional study of a tertiary hospital in Northern Nigeria.
Methods: Adult patients who have been attending the out‑patient clinic for at least 1 year were included. From the routine clinic, each consecutive fourth patient completed a socio‑demographic and drug use questionnaire, a self‑administered medication adherence scale, and a semi‑structured proforma which sought reasons for poor adherence, information on supervision and who keeps patient medications at home; until a calculated sample of 208 was attained.
Statistical Analysis: Done by means of descriptive statistics using the Statistical Package for Social Sciences version 16. The level of significance was set at P < 0.05.
Results: Totally, 208 patients participated in the study. 61 (29.3%) of them were substance users, out of which 59% never reported missing their medications. No statistically significant relationship was found between substance use and medication adherence. A significant proportion of substance users were compliant with medication use when the drugs were in their possession. For substance users and nonusers, the major reason for poor drug adherence was the unavailability of the medications, while nonsubstance users were more likely to complain about being tired of the medications. No report of side effects in supervised patients.
Conclusion: The use of psychoactive substances in patients with other mental disorders influences their medication adherence behavior.

Key words: Adherence, hospital, Nigeria, out‑patients, psychoactive, substance
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