Factors associated with non-adherence to medication among psychiatric out-patients in Benin-City, Nigeria
Background: Non-adherence to medication is common among patients with major psychiatric illnesses, and it is related to poor treatment outcome.
Aims and Objectives: To determine the prevalence of non-adherence to psychotropic medication among adult outpatients with major psychiatric illnesses; assess the risk factors for non-adherence and determine the effect of non-adherence on patients' functional status.
Methods: Adescriptive cross-sectional study was conducted among 355 outpatients of the psychiatric unit of a tertiary hospital. The Morisky Medication Adherence Scale (MMAS-8), The Global Assessment of Functions (GAF) and a Socio-demographic and clinical variable questionnaire were used to collect data which were analyzed using SPSS version 21. Level of statistical significance was set at 5% (P< 0.05).
Results: The overall prevalence of non-adherence to medication was 69.6%. The non- adherence rates in patients with bipolar disorder, major depression and schizophrenia were 62.4%, 67% and 77.7% respectively. Low educational level, poly-therapy, comorbidity, disturbing side effects and lack of insight were independent predictors of non-adherence. Mean GAF scores were significantly higher in adherent than non-adherent patients; non-adherent patients had a higher risk of low functional status.
Conclusions: The prevalence of non-adherence to medication was high among the sample of psychiatric patients in this study. Since, patients hardly spontaneously report their non-adherent behavior, physicians have the critical responsibility of assessing their patients for possible non-adherence, in order to achieve optimal treatment outcome.