Factors associated with medication adherence in patients with schizophrenia

Abstract

Introduction: Patients with schizophrenia require medication that is taken regularly for long periods of time. Non-adherence to antipsychotics is considered the main reason for hospital readmission. Objectives: To assess the prevalence of non-adherence in schizophrenic patients under antipsychotic treatment and to identify socio-demographic and clinical factors that might influence adherence to treatment. Methods: This prospective study was conducted in several psychiatric private practices located in Timișoara, between October 2014 and October 2016 and included 60 patients diagnosed with paranoid schizophrenia according to ICD-10 criteria, that were followed-up for six months. Clinical interviews, the BPRS – Brief Psychiatric Rating Scale (used to assess symptom severity) and a shorter version of the ROMI – Rating of Medical Influences scale (used to rate patient attitudes toward adherence) were applied at baseline. The BPRS was also used in the follow-up visits (once a month). We divided the patients into two samples considering treatment adherence and we compared data. Results: For the whole sample, the mean disorder duration was 12.6 ± 7.6 years and the mean number of hospitalizations was 6.4 ± 4.5. Younger patients were more adherent to treatment than elderly patients, whilst single patients or those living alone were more frequently non-adherent. We obtained statistically significant differences between the study groups (adherent vs. non-adherent) regarding disorder duration (p=0.04) and mean number of hospitalizations (p=0.02). The main two reasons for non-adherence to pharmacotherapy were discomfort caused by the medication's adverse effects (37.5%), and the fact that medication is not currently needed – from the patient's standpoint (21.8%). The most important reasons for adherence to pharmacotherapy were: the perceived daily benefit brought on by antipsychotic medication (32.1%) and relapse prevention (17.9%). Conclusions: Age, marital status, and disorder duration are factors with the most important influence on treatment adherence.