Rate of Nonadherence to Antipsychotic Medications and Factors Leading to Nonadherence among Psychiatric Patients in Gondar University Hospital, Northwest Ethiopia
Objective. The main aim of this study was to assess the rate of medication nonadherence among psychiatry patients at University of Gondar Hospital. Materials and Methods. Cross-sectional, descriptive method was conducted over a period of one month in May, 2013, at University of Gondar Hospital. Rate of nonadherence was computed using Medication Adherence Rating Scale questionnaire and self-reporting via a structured patient interview. Chi-square was used to determine the statistical significance of the association of variables with adherence. Result. Out of 209 respondents, 105 (50.2%) were found to be nonadherent. Patients who were forced to take their medication against their will (), those who did not believe they require medication (), and those who discontinued their medication without consulting their prescriber () had significant association with nonadherence. Adherence among schizophrenia was 75.7%; psychotic was 46.7%; bipolar disorder was 37.5%; and psychosis with depression was 52.6%. Reasons for nonadherence included recovery from the illness (26.7%), seeking alternative therapy and unavailability of drugs (18.1% each), adverse drug reaction (12.7%), forgetfulness (10.6%), and being busy (8.6%). Conclusion. The observed rate of antipsychotic medication nonadherence in this study was high. Interventions to increase adherence are therefore crucial. 1. Introduction Adherence to medication regimens has been monitored since the time of Hippocrates [1]. Adherence to a medication regimen is generally defined as the extent to which patients take medications as prescribed by their health care providers. It is clear that the full benefit of the many effective medications that are available will be achieved only if patients follow prescribed treatment regimens reasonably [2]. Because of the difficulties in measuring adherence, no estimate of adherence or nonadherence can be generalized, but poor adherence is to be expected in 30–50% of all patients, irrespective of disease, prognosis, or setting [3]. Study done in Washington showed that 74% of outpatients with schizophrenia stop taking neuroleptics or antipsychotics within two years of leaving a hospital and 20 to 57% patients with bipolar affective disorder are nonadherent [4]. Nonadherence to medication is known to be associated with poorer treatment outcomes, particularly in the management of chronic disease. In the treatment and management of psychotic disorders, the maximum benefit that a patient derives from these medications is highly dependent on their adherence to treatment. Although
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