Evaluation of Medication Adherence and its Predictors Among Psychiatric Outpatients at a Mental Healthcare Hospital in Lahore, Pakistan: A Cross-Sectional Study

Authors

  • Ayesha Shaheen Sarwar Department of Pharmacy, Quaid-i-Azam University , Islamabad, Pakistan
  • Ahmad Khan Department of Pharmacy, Quaid-i-Azam University , Islamabad, Pakistan
  • Tahir Mehmood School of Natural Sciences, National University of Sciences and Technology, Islamabad, Pakistan
  • Jallat Khan Department of Chemistry, Khuwaja Fareed University of Engineering and Information Technology, Rahim Yar Khan, Punjab, Pakistan
  • Obaidullah Malik Drug Regulatory Authority of Pakistan, Islamabad, Pakistan
  • Munira Johar Saeed Akhtar College of Nursing, DAKSON Institute of Health Sciences, Islamabad, Pakistan

Keywords:

Predictors, non-adherence, psychiatry, psychotropic medication, mental disorders, outpatients

Abstract

The study aimed to assess the level of medication adherence among psychiatric outpatients and to determine the main predictors associated with medication non-adherence. A cross sectional study was conducted among 298 psychiatric outpatients at Punjab Institute of Mental Health (PIMH), Lahore, Pakistan. A designed questionnaire was used as data collection tool and adherence was evaluated using MARS (Medication Adherence Rating Scale). Data was analyzed using SPSS version 21.0. Logistic regression was applied to determine the predictors of non-adherence. Medication adherence rate varied from low (39.3%) to high (60.7%) adherence. The impact of demographic factors such as age, gender, diagnosis, employment status and comorbidity on medication adherence were insignificant.

Results of chi-square found that marital status, duration of illness from last visit, patient factors, medication factors, disease factors were significantly associated with adherence (p<0.05). Multivariate binary logistic regression indicated that qualification, marital status, number of tablets per day, duration of illness from last visit, patient factors, disease factors were the main predictors of medication non-adherence. 

References

. WHO, “Investing in mental health,” Who, pp. 3–49, 2003.

. I. Ansari, “Mental Health Pakistan: Optimizing brains,” Int. J. Emerg. Ment. Health, vol. 17, no. 1, p. 288, 2015.

. K. B. Thakkar, M. M. Jain, G. Billa, A. Joshi, and A. A. Khobragade, “A drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital,” J. Clin. Diagnostic Res., vol. 7, no. 12, pp. 2759–2764, 2013.

. F. Taj et al., “Factors associated with non-adherence among psychiatric patients at a tertiary care hospital, Karachi, Pakistan: a questionnaire based cross-sectional study,” J. Pak. Med. Assoc., vol. 58, no. 8, pp. 432–436, 2008.

. R. Horne, J. Weinman, N. Barber, and R. Elliott, “Concordance, adherence and compliance in medicine taking Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO),” Natl. Co-ord. Cent. NHS Serv. Deliv. Organ. R D, pp. 1–331, 2005.

. World Health Organization, “Adherence to long term therapies; evidence for action,” 2003.

. J. A. Cramer, “Compliance with medication regimens for mental and physical disorders,” Psychiatr. Serv., vol. 49, 1998.

. H. Odo, S. Olotu, J. Soni, B. James, I. Agbonile, and P. Esan, “Assessment of adherence to psychotropic medications among out-patients at the Pharmacy Department of a Psychiatric Hospital, in Benin City, Nigeria,” Asian J. Pharm., vol. 8, no. 4, p. 211, 2014.

. D. I. Velligan et al., “Relationships Among Subjective and Objective Measures of Adherence to Oral Antipsychotic Medications,” Psychiatr. Serv., vol. 58, no. 9, pp. 1187–1192, Sep. 2014.

. M. A. Chisholm-burns et al., “O RIGINAL A RTICLE US Pharmacists ’ Effect as Team Members on Patient Care Systematic Review and Meta-Analyses,” Med. Care, vol. 48, no. 10, pp. 923–933, 2010.

. P. Sharmila Nirojini, M. Bollu, and R. R. Nadendla, “Prevalence of medication non-adherence among the psychiatric patients - Results from a survey conducted in a tertiary care hospital,” Int. J. Pharm. Pharm. Sci., vol. 6, no. 4, pp. 461–463, 2014.

. T. Eticha, A. Teklu, D. Ali, G. Solomon, and A. Alemayehu, “Factors associated with medication adherence among patients with schizophrenia in Mekelle, Northern Ethiopia,” PLoS One, vol. 10, no. 3, pp. 1–11, 2015.

. R. L. Cutler, F. Fernandez-llimos, M. Frommer, C. Benrimoj, and V. Garcia-cardenas, “Economic impact of medication non- adherence by disease groups : a systematic review,” BMJ, pp. 1–13, 2018.

. “Adherence According to Mary Poppins: Strategies to Make the Medicine Go Down,” Perspect. Psychiatr. Care, vol. 46, no. 1, pp. 3–13, 2010.

. S. C. E. Chapman and R. Horne, “Medication nonadherence and psychiatry,” Current Opinion in Psychiatry, vol. 26, no. 5. Wolters Kluwer Health, pp. 446–452, Sep-2013.

. M. Alsalem, “Psychotropic Medication Non-adherence among Psychiatric Patients at King Abdulaziz Hospital-Makkah,” Int. Neuropsychiatr. Dis. J., vol. 10, no. November, pp. 1–11, 2017.

. A. Ghaffari-Nejad, A. Mashayekhi, S. Mazhari, and A. Ghayoumi, “Factors Associated With Drug Non-Adherence After Discharge Among Patients With Mood Disorders Hospitalized in Shahid Beheshti Hospital in Kerman: A Prospective Study,” Zahedan J. Res. Med. Sci., vol. 17, no. 4, 2015.

. K. Tesfay, E. Girma, A. Negash, M. Tesfaye, and S. Dehning, “Medication Non-Adherence among Adult Psychiatric Out-patients in Jimma University Specialized Hospital, Southwest Ethiopia,” Ethiop. J. Health Sci., vol. 23, no. 3, 2013.

. K. Tesfay, E. Girma, A. Negash, M. Tesfaye, and S. Dehning, “Medication non-adherence among adult psychiatric out patients in Jimma University Specialized Hospital, Southwest Ethiopia.,” Ethiop. J. Health Sci., vol. 23, no. 3, pp. 227–36, Nov. 2013.

. Sanele Mahaye, “Medication adherence of psychiatric patients in an outpatient setting,” African J. Pharm. Pharmacol., vol. 6, no. 9, pp. 608–612, 2012.

. M. Tareke, S. Tesfaye, D. Amare, T. Belete, and A. Abate, “Antipsychotic medication non-adherence among schizophrenia patients in Central Ethiopia,” South African J. Psychiatry, vol. 24, no. 0, p. 6, Mar. 2018.

. T. L. Mukattash et al., “Prevalence of non-adherence among psychiatric patients in Jordan, a cross sectional study,” Int. J. Pharm. Pract., vol. 24, no. 3, pp. 217–221, May 2016.

. Kn. Rao, J. George, C. Sudarshan, and S. Begum, “Treatment compliance and noncompliance in psychoses,” Indian J. Psychiatry, vol. 59, no. 1, p. 69, 2017.

. T. J. Hudson et al., “A pilot study of barriers to medication adherence in schizophrenia,” J. Clin. Psychiatry, vol. 65, no. 2, pp. 211–216, Feb. 2004.

. B. Janssen, W. Gaebel, M. Haerter, F. Komaharadi, B. Lindel, and S. Weinmann, “Evaluation of factors influencing medication compliance in inpatient treatment of psychotic disorders,” Psychopharmacology (Berl)., vol. 187, no. 2, pp. 229–236, Aug. 2006.

. J. A. Kasper, S. K. Hoge, T. Feucht-Haviar, J. Cortina, and B. Cohen, “Prospective study of patients’ refusal of antipsychotic medication under a physician discretion review procedure,” Am. J. Psychiatry, vol. 154, no. 4, pp. 483–489, Apr. 1997.

. S. K. Hoge et al., “A Prospective, Multicenter Study of Patients’ Refusal of Antipsychotic Medication,” Arch. Gen. Psychiatry, vol. 47, no. 10, pp. 949–956, Oct. 1990.

. C. G. Maan, M. S. Hussain, N. Heramani, and R. K. Lenin, “Factors affecting non-compliance among psychiatric patients in the regional institute of medical sciences, imphal,” Indian J. Psychiatry, vol. 57, no. 5, pp. 01–07, 2015.

. A. Elixhauser, S. A. Eisen, J. C. Romeis, and S. M. Homan, “The Effects of Monitoring and Feedback on Compliance,” Med. Care, vol. 28, no. 10, pp. 883–93, Oct. 1990.

. R. Taj and S. Khan, “A study of reasons of non-compliance to psychiatric treatment.,” J. Ayub Med. Coll. Abbottabad, vol. 17, no. 2, pp. 26–8.

. A. Endale Gurmu, E. Abdela, B. Allele, E. Cheru, and B. Amogne, “Rate of Nonadherence to Antipsychotic Medications and Factors Leading to Nonadherence among Psychiatric Patients in Gondar University Hospital, Northwest Ethiopia,” Adv. Psychiatry, vol. 2014, pp. 1–5, 2014.

. H. Jónsdóttir, S. Friis, R. Horne, K. I. Pettersen, Å. Reikvam, and O. A. Andreassen, “Beliefs about medications: Measurement and relationship to adherence in patients with severe mental disorders,” Acta Psychiatr. Scand., vol. 119, no. 1, pp. 78–84, Jan. 2009.

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Published

2020-01-27

How to Cite

Sarwar, A. S. ., Khan, A. ., Mehmood, T. ., Khan, J. ., Malik, O. ., & Johar, M. . (2020). Evaluation of Medication Adherence and its Predictors Among Psychiatric Outpatients at a Mental Healthcare Hospital in Lahore, Pakistan: A Cross-Sectional Study. American Scientific Research Journal for Engineering, Technology, and Sciences, 63(1), 193–204. Retrieved from https://www.asrjetsjournal.org/index.php/American_Scientific_Journal/article/view/5856

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