Self-Reported Antidepressant Drug Side Effects, Medication Adherence, and Its Associated Factors among Patients Diagnosed with Depression at the Psychiatric Hospital of Nepal.

Nirmal Raj Marasine,Rajendra Lamichhane,Nim Bahadur Dangi,Nabin Raj Marasini,Sabina Sankhi,Misgan Legesse Liben

doi:10.1155/2020/7024275

Abstract

Objective The present study is aimed at evaluating the side effects of antidepressant drugs, medication adherence (MA), and associated factors among patients diagnosed with depression at a psychiatric hospital in western Nepal. Methods A prospective cross-sectional study was conducted among 174 patients visiting the outpatient clinic of a psychiatric hospital. The antidepressant side effect checklist (ASEC) was used to classify the reported antidepressant drug side effects into mild, moderate, and severe types. The Naranjo adverse drug reaction (ADR) probability scale was employed to assess the ADRs, and the Morisky Green Levine Adherence (MGLA) score was employed to determine the rate of medication adherence. Descriptive statistics and bivariate analysis were used, and a P value < 0.05 was taken as statistically significant in the multivariate analysis. Results The patients were mostly female (55.74%), with a median (IQR) age of 32 (20) years. Approximately 74.13% of the patients experienced antidepressant side effects, where insomnia (17.05%) and anxiety (17.05%) were the most common. More than half of the patients (52.29%) had a low level of adherence. Females were 1.01 times more likely to be nonadherent to their antidepressant medications compared to males, adjusted odds ratio (AOR): 1.001 (0.31-1.63). Similarly, illiterate patients tended to be more nonadherent compared to literates, AOR: 1.342 (0. 93-2.82), and unemployed individuals were 1.5 times more likely to be nonadherent to their medications compared to employed individuals, AOR: 1.46 (1.16-4.13). Likewise, patients with severe side effects were more prone to develop nonadherence than those with moderate side effects, AOR: 1.173 (0.42-3.25). A significant association was found between the Naranjo score and medication adherence. Conclusions This study suggests that antidepressant drug side effects were more prevalent and medication adherence was extremely poor among depressive patients in psychiatric hospitals. Factors such as gender, occupation, education, side effects, and ADRs attributed to poor medication adherence in patients.

Highlights

Depression, a common chronic psychiatric illness, interferes with physical and mental performance as well as the social life of the individual
This study revealed that the antidepressant drug side effects were more prevalent and that the level of medication adherence was extremely poor among depressive patients
This study revealed that in depressive patients, self-reported antidepressant drugs side effects were highly prevalent, and anxiety, insomnia, dry mouth, and weight gain were more frequent

Summary

Introduction

Depression, a common chronic psychiatric illness, interferes with physical and mental performance as well as the social life of the individual. More than 264 million people worldwide suffer from depression [1]. Organization (WHO) estimated that by year 2020, it would become the second-highest known cause of worldwide disability [2], and by 2030, it would possibly become the most significant factor contributing to the global burden of disease [3]. Nepal has a high prevalence of depression with the second-highest rate of “disability-adjusted life years” in the Depression Research and Treatment world [4]. In Nepal, 1 in every 3 people suffers from mental illness, and more than 90 percent of the population in need of mental health services has no access to treatment [4]. The first epidemiological field survey conducted in the Kathmandu valley by the government of Nepal in 1984 estimated the prevalence of mental illness to be approximately 14% [5]

Results

Discussion

Conclusion