Initial adherence by psychiatric outpatients in a general hospital and relevant personal factors

Minhua Chen,Xianglan Wang,Liyun Lu,Yongli Pang,Li Ye,Gelin Lin,Lina Zhou

doi:10.1186/s12888-022-03797-3

Abstract

BackgroundInitial adherence is a predictor of long-term adherence and thus is a crucial metric to explore and support. This study aimed to investigate initial adherence by psychiatric outpatients and relevant personal factors.MethodsThe study surveyed psychiatric outpatients using a 30-day timely return visit rate (TRVR) after the first visit to indicate initial adherence. All participants agreed to engage in the self-designed survey and assessments of the Eysenck Personality Questionnaire (EPQ) and Symptoms Checklist-90 (SCL-90). Clients who missed timely return visits received telephone follow-up to determine the main reasons.ResultsThe overall TRVR was 59.4, and 40.6% of clients missed return visits. Logistic regression analysis revealed risk factors for initial adherence were work, tense family atmosphere, negative attitudes towards medication, higher EPQ psychoticism score, and lower SCL-90 phobic anxiety score. The main reasons given for non-timely return visits were improvement suggesting lack of need for a return visit, various barriers, no improvement, and side effects.ConclusionPsychiatric outpatients had poor initial adherence related to multiple dimensional factors, including job, family, personality characteristics, mental status, and thoughts about mental illness and treatments.

Highlights

Initial adherence is a predictor of long-term adherence and is a crucial metric to explore and support
This study focused on the profile of the initial adherence by psychiatric outpatients and its relevant personal factors
The timely return visit rate (TRVR) was highest for the 46–55-year-old subgroup (66.8%) and lowest for the 26–35-year-old subgroup (55.3%) (χ2 = 15.409, P = 0.004)

Summary

Introduction

Initial adherence is a predictor of long-term adherence and is a crucial metric to explore and support. The International Society for Pharmacoeconomics and Outcomes Research proposed two types of medical adherence: initial (IMA) and long-term (LTA). IMA refers to adherence after being prescribed a new drug, and LTA refers to adherence during continuous medication or long-term treatment [2, 3]. There is no consistent definition of the “initial” phase with most studies defining it as 14 to 28 days after a new prescription or the first visit but others including periods of months or even a year [2]. Initial adherence is a more widely concept describing illness behavior than IMA. This study defined the initial phase as 30 days after the first visit and used timely return visit (TRV) behavior as the outcome indicator of initial adherence

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