Do Community Free-Medication Service Policy Improve Patient Medication Adherence? A Cross-Sectional Study of Patients With Severe Mental Disorders in Beijing Community.

Junli Zhu,Rui Xi,Yun Chen,Dan Li,Wei Lu,Qingzhi Huang,Ying Xu,Bin Li

doi:10.3389/fpubh.2021.714374

Junli Zhu, Rui Xi + Show 6 more

Open Access

https://doi.org/10.3389/fpubh.2021.714374

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Abstract

Background: Nowadays, mental health problems have become a major concern affecting economic and social development, with severe mental health disorders being the top priority. In 2013, Beijing began to implement the Community Free-Medication Service policy (CFMS). This article aims to evaluate the effect of the policy on medication adherence.Methods: In this study, multi-stage sampling was used to select representative patients as samples. Some of the baseline data were obtained by consulting the archives, and information about patient medication adherence measured by Brooks Medication Adherence Scale was obtained through face-to-face interviews. Logistic regression was used to examine the impact of the policy.Results: Policy participation had a significant positive impact on medication adherence (OR = 1.557). The effect of policy participation on medication adherence in the Medication-only mode and Subsidy-only mode were highly significant, but it was not significant in the Mixed mode.Conclusion: This study found that the CFMS in Beijing as an intervention is effective in improving the medication adherence of community patients. However, the impact of the policy is not consistent among service modes. Reinforcement magnitude and frequency should be considered when designing reinforcement interventions.

Highlights

Mental health problems have become major public health and social problems, affecting economic, and social development
The basic characteristics of the overall respondents in this study are shown in Table 1. 948 (57.8%) had good medication adherence within 12 months
The proportions of respondents suffering from schizophrenia (SCH), bipolar disorder (BD), and Intellectual Disability with mental disorders (ID-MD) are 57.0, 15.1, and 17.9%, respectively, with 79.8% having a disease course of 10 years or longer

Summary

Introduction

Mental health problems have become major public health and social problems, affecting economic, and social development. A study by the Harvard School of Public Health projected that between 2011 and 2030, mental disorders will cause up to 16.3 trillion US dollars in economic output losses worldwide [1]. Poor adherence to antipsychotic drugs is a major problem in the treatment of psychotic disorders. Previous many literature have shown between 25 and 80% of patients fail to take their drugs correctly at some point in their treatment [2] and poor adherence has been strongly associated with a higher risk of relapse, increased hospitalisation rates, lower rates of remission of positive symptoms and a poorer quality of life [3, 4]. Mental health problems have become a major concern affecting economic and social development, with severe mental health disorders being the top priority. This article aims to evaluate the effect of the policy on medication adherence

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