Effect of psycho-educational intervention on drug adherence and quality of life among patients with Schizophrenia in Jigawa State, Nigeria

Abstract

Adherence to psychiatric medications is a complex, dynamic behavior requiring patients to initiate treatment and continue to take their medications; at the correct time, in the correct dose, for prolonged periods of time. But, improving adherence in schizophrenia may have a considerable positive impact on patients and society in terms of quality of life. This can be achieved by focusing on the identified multitude of factors driving non-adherence. Aim: To evaluate the effect of psycho-education intervention on adherence to drug and quality of life among patients with schizophrenia in Jigawa State, Nigeria. Method: A quasi-experimental study was conducted with before and after design among caregivers and schizophrenic patients selected from some hospitals in Jigawa State. The study population comprised of all eligible schizophrenic patients and their caregivers within the study area. One hundred and thirty each for both the experimental and control group among the study participants were selected using a multistage sampling technique. Data was entered, coded and analyzed using SPSS version 22. Results: There was an increase in the knowledge of schizophrenia and medication adherence, quality of life and level of medication adherence after the psycho-education intervention among the study participants. The predictors of medication adherence among the study participants in the experimental group include: type of treatment (ECT) (AOR=0.25, 95%CI= 0.18 – 0.75) was found to be negative predictor of medication adherence to treatment among study participants. While, cost of treatment of more than one thousand five hundred naira per day (AOR=3.00, 95%CI=2.83 – 12.24), occupational status of civil servants (AOR=2.00, 95%CI=1.11–14.33); housewives (AOR=4.03, 95%CI=2.14 – 12.33) and business (AOR=2.01, 95%CI=1.55 – 12.56), combination of drugs and ECT (AOR=4.03, 95%CI=2.75 – 17.53), presence of side effects (AOR=3.00, 95%CI=2.75-15.76) were positive predictors of good medication adherence among the study participants in the experimental group. While, the predictors of quality of life among the study participants in the experimental group include the following: cost of treatment of more than one thousand five hundred naira per day (AOR=4.03, 95%CI=3.56 – 12.45), contact with health care providers i.e Psychiatrist (AOR=4.11, 95%CI=2.33-16.76) and Psychiatrist Nurse (AOR=2.55, 95%CI=1.99-18.46) and presence of side effects (AOR=1.67, 95%CI=1.33-11.57) were positive predictors of good quality of life among the study participants in the experimental group. Conclusion: Following psycho-education as an intervention among the experimental group; there was an improvement in the knowledge on schizophrenia, medication adherence, quality of life and factors affecting quality of life six month after the intervention (psycho-education). It was recommended that Psycho-education should be included as part of management plan to all newly diagnosed schizophrenic patients and at least one of their care givers.