Factors Associated with Non-Adherence to Medication Among Patients with Schizophrenia at Ndera Neuropsychiatric Hospital

Abstract

Background:

Schizophrenia is mental disorder which is defined as a chronic disease that affects how individual feels, thinks and behavior. The prevalence of the disorder is about 1% of the population worldwide. Taking medication as prescribed by healthcare provider is a core part of recovery form sickness through control of symptoms. The consequence of non-adherence is relapse and that can explain more admission in emergency service, re-hospitalization, increased cost to healthcare system and need for clinicians. Non-adherence potential factors may be linked to disease, treatment or environmental like therapeutic support. However, no study to date conducted to determine the poor adherence factors to antipsychotic medicine at Ndera Neuropsychiatric Hospital, prior to this study. Methods:

This study was conceived as a descriptive cross-sectional study for determining poor adherence factors to antipsychotic medicine among schizophrenic patients at Ndera Neuropsychiatric Hospital. Data collection was made using a questionnaire. This study was designed as mixed method study with cross-sectional design in the quantitative part and additional qualitative design to explore the factors associated with poor adherence. Statistical analysis was performed, and SPSS (version 21) was use to analyze numerical data. Qualitative data were also analyzed by using thematic method analysis in order to give them a meaning with reference to the COM¬B. Results: Three hundred and forty-three patients diagnosed with schizophrenia and followed at NDERA Neuro-Psychiatric Hospital were recruited and 26.2% of participants were adherent to antipsychotic medications, 56.9% were found to be partially adherent and 16.9% were not adherents to the prescribed medications. Level of education was found to be associated with compliance to prescribed medications where 36.5% of patient with university level were adherent, 23.4 % of participants who had primary education level were adherent and 21.5% of participants with no education were adherent (p< 0.001). Married patients tend to be adherent to mediation compared to other categories (p=0.045) and employed participants were more adherent than other employment categories (p=0.013).

Participants from urban region were found to be compliant to prescribed medication compared to patients from rural area and the difference was significant (p<0.001). Lack of social support, poor understanding of the disease, stigma of disease, cost of medications, poor communication with health care providers, fear of medication side effects and religious beliefs were among the most expressed factors that affect adherence. Statistical no significant difference among age group, gender, and religion group regarding adherence. Conclusion: The poor adherence rate for antipsychotic medications is high among schizophrenic patients followed at Ndera Neuropsychiatric Hospital. Patients from rural area showed to have poor adherence to medications compared to patients from urban region. Lack of means to buy medications and pay travel, fear of side effects from medications, lack of understanding of the disease and low education, stigma, chronicity of the condition and social behaviors were among the factors of non-adherence mentioned by the participants.