Prevalence of Medication Non-Adherence among Psychiatric Patients in a Tertiary Hospital in Nigeria

Abstract

Background: The consequences of non-adherence to prescribed medications by psychiatric patients for both patients and the health care system are myriad and grave. Aim: The study was designed to ascertain the prevalence of medication non-adherence among psychiatric patients and identify factors that aid this malady. Methods: This prospective, cross-sectional study was carried out within a 4 month period at the out-patient psychiatric clinic of the University of Port Harcourt Teaching Hospital; using the Medication Adherence Rating Scale (MARS) and a self designed questionnaire containing socio-demographic and psychiatric illness variables. Results: A total number of 111 patients who participated in the study were analyzed. The cohort comprises 22 (19.8%) schizophrenics, 38 (34.2%) mood disorder patients, 24 (21.6%) anxiety disorder patients, 10 (9.0%) patients suffering from substance abuse and 17 (15.3%) with other psychiatric diagnoses (somatoform and personality disorders). Most of the patients were male (53; 47.7%), aged between 21 - 30 yrs (44; 39.6%), unemployed (38; 34.2%), as single (58; 52.3%). The prevalence of non-adherence to medications among the cohort studied is 39.6%. There was a significant association between consistency in taking one’s medications and MARS scores but none between socio-demographic variables and MARS score. Conclusion: The rate of medication non adherence among the subjects in this study was 39.6%. The three most important reasons reported for this behaviour include: Feeling that they had recovered from their illness and hence have been cured, belief that their illness was of a spiritual origin and hence would not be amenable to orthodox medicine and the side effects of the medications. Non adherence to medication increases the risk of psychiatric morbidity and mortality and efforts at curbing this trend must be eclectic.