Ethnic difference in medication adherence and compounding factors in treatment of early stages of psychotic disorders

Abstract

Introduction Studies shown ethnic difference in illness-awareness, medication acceptance, difference in types and doses of medication prescribed in certain ethnic groups in treatment of psychosis. Objectives To study antipsychotic adherence patterns in ethnic groups and to study factors influencing. Aims To analyse any difference in the adherence patterns between ethnic groups and identify factors mediating any effects. Methods One hundred and twenty-seven consecutive patients presenting to early-intervention service in South-London included in naturalistic study. Sample binarised into Caucasian (white British, other white background, n =36, 28%) and combined Black and Minority Ethnic (BME, n =91, 72%) groups. Medication adherence studied using self and carer reports, looking for percentage of times taking medications, any gaps in treatment (atleast 1 month). Range of demographic and clinical parameters collected including use of substances and medications side-effects. Results Patients with treatment gap (atleast 1 month) had similar demographic and clinical characteristics with the rest, except the former were more likely to have reported extra-pyramidal (EPSE) (Pearson χ 2 =5.6, df=1, P =0.02), and to be BME rather than Caucasian (BME n =57, 64%, Caucasian n =16. 44%, Pearson χ 2 =4.5, df=1, P =0.05). These variables were further entered in stepped multivariate regression, only the effect of EPSE remained significant, with odds ratio 8, P =0.05. There was no difference in Chlorpromazine equivalent dose between ethnic groups (Caucasian mean-dose 156 mg, BME 138 mg, t =1.2, P =0.2). Also there was no significant difference in types of antipsychotics prescribed (χ 2 =4, P =0.1, df=2) between the ethnic groups. Conclusions Ethnic difference in antipsychotic adherence may also be influenced by sensitivity to certain side effects.