Correlates of poor medication adherence in chronic psychotic disorders
Background Chronic psychotic disorders (CPDs) occur worldwide and cause significant burden. Poor medication adherence is pervasive, but has not been well studied in sub-Saharan Africa. Aims This cross-sectional survey of 100 poorly adherent Tanzanian patients with CPD characterised clinical feature...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-01-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472420001416/type/journal_article |
| _version_ | 1811157026834743296 |
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| author | Martha Sajatovic Jessie Mbwambo Isaac Lema Carol Blixen Michelle E. Aebi Betsy Wilson Godwin Njiro Christopher J. Burant Kristin A. Cassidy Jennifer B. Levin Sylvia Kaaya |
| author_facet | Martha Sajatovic Jessie Mbwambo Isaac Lema Carol Blixen Michelle E. Aebi Betsy Wilson Godwin Njiro Christopher J. Burant Kristin A. Cassidy Jennifer B. Levin Sylvia Kaaya |
| author_sort | Martha Sajatovic |
| collection | DOAJ |
| description | Background
Chronic psychotic disorders (CPDs) occur worldwide and cause significant burden. Poor medication adherence is pervasive, but has not been well studied in sub-Saharan Africa.
Aims
This cross-sectional survey of 100 poorly adherent Tanzanian patients with CPD characterised clinical features associated with poor adherence.
Method
Descriptive statistics characterised demographic and clinical variables, including barriers to adherence, adherence behaviours and attitudes, and psychiatric symptoms. Measures included the Tablets Routine Questionnaire, Drug Attitudes Inventory, the Brief Psychiatric Rating Scale, the Clinical Global Impressions scale, the Alcohol Use Disorders Identification Test and Alcohol, Smoking and Substance Involvement Screening Test. The relationship between adherence and other clinical variables was evaluated.
Results
Mean age was 35.7 years (s.d. 8.8), 61% were male and 80% had schizophrenia, with a mean age at onset of 22.4 (s.d. 7.6) years. Mean proportion of missed CPD medication was 64%. One in ten had alcohol dependence. Most individuals had multiple adherence barriers. Most clinical variables were not significantly associated with the Tablets Routine Questionnaire; however, in-patients with CPD were more likely to have worse adherence (P ≤ 0.01), as were individuals with worse medication attitudes (Drug Attitudes Inventory, P < 0.01), higher CPD symptom severity levels (Brief Psychiatric Rating Scale, P < 0.001) and higher-risk use of alcohol (Alcohol Use Disorders Identification Test, P < 0.001).
Conclusions
Poorly adherent patients had multiple barriers to adherence, including poor attitudes toward medication and treatment, high illness acuity and substance use comorbidity. Treatments need to address adherence barriers, and consider family supports and challenges from an intergenerational perspective.
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| first_indexed | 2024-04-10T04:59:23Z |
| format | Article |
| id | doaj.art-a0df58871d18456190486ccce722ad71 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:23Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-a0df58871d18456190486ccce722ad712023-03-09T12:29:05ZengCambridge University PressBJPsych Open2056-47242021-01-01710.1192/bjo.2020.141Correlates of poor medication adherence in chronic psychotic disordersMartha Sajatovic0https://orcid.org/0000-0002-3073-668XJessie Mbwambo1Isaac Lema2Carol Blixen3Michelle E. Aebi4Betsy Wilson5Godwin Njiro6Christopher J. Burant7Kristin A. Cassidy8Jennifer B. Levin9Sylvia Kaaya10Department of Psychiatry, Department of Neurology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Ohio, USADepartment of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, TanzaniaDepartment of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, TanzaniaDepartment of Psychiatry and Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine, Ohio, USADepartment of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Ohio, USADepartment of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Ohio, USADepartment of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, TanzaniaFrances Payne Bolton School of Nursing, Case Western Reserve University, Ohio, USADepartment of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Ohio, USADepartment of Psychiatry and Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Ohio, USADepartment of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, TanzaniaBackground Chronic psychotic disorders (CPDs) occur worldwide and cause significant burden. Poor medication adherence is pervasive, but has not been well studied in sub-Saharan Africa. Aims This cross-sectional survey of 100 poorly adherent Tanzanian patients with CPD characterised clinical features associated with poor adherence. Method Descriptive statistics characterised demographic and clinical variables, including barriers to adherence, adherence behaviours and attitudes, and psychiatric symptoms. Measures included the Tablets Routine Questionnaire, Drug Attitudes Inventory, the Brief Psychiatric Rating Scale, the Clinical Global Impressions scale, the Alcohol Use Disorders Identification Test and Alcohol, Smoking and Substance Involvement Screening Test. The relationship between adherence and other clinical variables was evaluated. Results Mean age was 35.7 years (s.d. 8.8), 61% were male and 80% had schizophrenia, with a mean age at onset of 22.4 (s.d. 7.6) years. Mean proportion of missed CPD medication was 64%. One in ten had alcohol dependence. Most individuals had multiple adherence barriers. Most clinical variables were not significantly associated with the Tablets Routine Questionnaire; however, in-patients with CPD were more likely to have worse adherence (P ≤ 0.01), as were individuals with worse medication attitudes (Drug Attitudes Inventory, P < 0.01), higher CPD symptom severity levels (Brief Psychiatric Rating Scale, P < 0.001) and higher-risk use of alcohol (Alcohol Use Disorders Identification Test, P < 0.001). Conclusions Poorly adherent patients had multiple barriers to adherence, including poor attitudes toward medication and treatment, high illness acuity and substance use comorbidity. Treatments need to address adherence barriers, and consider family supports and challenges from an intergenerational perspective. https://www.cambridge.org/core/product/identifier/S2056472420001416/type/journal_articleAntipsychoticspsychosisschizophreniamedicationtreatment adherence |
| spellingShingle | Martha Sajatovic Jessie Mbwambo Isaac Lema Carol Blixen Michelle E. Aebi Betsy Wilson Godwin Njiro Christopher J. Burant Kristin A. Cassidy Jennifer B. Levin Sylvia Kaaya Correlates of poor medication adherence in chronic psychotic disorders BJPsych Open Antipsychotics psychosis schizophrenia medication treatment adherence |
| title | Correlates of poor medication adherence in chronic psychotic disorders |
| title_full | Correlates of poor medication adherence in chronic psychotic disorders |
| title_fullStr | Correlates of poor medication adherence in chronic psychotic disorders |
| title_full_unstemmed | Correlates of poor medication adherence in chronic psychotic disorders |
| title_short | Correlates of poor medication adherence in chronic psychotic disorders |
| title_sort | correlates of poor medication adherence in chronic psychotic disorders |
| topic | Antipsychotics psychosis schizophrenia medication treatment adherence |
| url | https://www.cambridge.org/core/product/identifier/S2056472420001416/type/journal_article |
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