Predictors of therapeutic adherence in psychiatric inpatients with schizophrenia

Abstract

Background and objectives. The current research aims to better understand patients’ adherence rates to medication and the predictors for such behaviors. Low adherence to antipsychotics has been an issue for the longest time, being up to 70% in some cases, and it is linked to worsening symptoms, relapse, a greater use of emergency psychiatric services, higher costs, and poor outcomes. The study sample was divided into 2 groups based on their attitude towards medication (adherent and nonadherent group), and we strived to find correlations between them and certain demographics, lifestyles, or treatments. The purpose of this paper was to obtain results that would provide valuable insights into the understanding and approach of schizophrenia patients when it comes to antipsychotic treatment and overall well-being. Materials and methods. The data was collected by reviewing previous medical records, conducting semi-structured interviews, and using the DAI-10 questionnaire (a self-report questionnaire) to obtain adherence levels. Simultaneously, we obtained data from the medical staff, family members, and friends of the patients when possible. Results. In this study, it was found a significant correlation between nonadherence and living arrangements, with nonadherent patients diagnosed with schizophrenia being more likely to live alone (p-value of 0.039 and a 95% CI of 0.008 to 0.881). In addition, nonadherent individuals had a significantly higher number of hospital admissions compared to the compliant group (p-value of 0.041 and a 95% CI of 0.824 to 0.996). There wasn’t a significant correlation between adherence and other socio-demographic factors (age, gender, living environment, educational level, employment, and marital status) or medical history and treatment (age of onset, duration of illness, antipsychotic medication, and method of administration). Conclusions. These findings highlight the great morbidity and isolation that comes with this kind of illness. Even though it’s a rare disease, it carries great suffering and economic costs. Further studies should focus on using multiple methods simultaneously in assessing treatment compliance, especially objective methods, and conduct more longitudinal studies than cross-sectional with bigger study samples.