Alcohol use in Tanzanians with chronic psychotic disorders and poor medication adherence.

Journal: The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa

Volume: 27

Issue: 

Year of Publication: 

Affiliated Institutions:  School of Medicine, Case Western Reserve University, Cleveland, The United States of America. Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, The United States of America. Department of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Republic of Tanzania.

Abstract summary 

The burden of chronic psychotic disorders (CPDs) in sub-Saharan Africa (SSA) is significant. Poorly medically adherent patients are more likely to have worse outcomes and require more resources. However, factors impacting effective treatment of CPD in this population are unclear.Examine the relationship between alcohol use and disease management and compare alcohol risk stratification between the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in poorly medication adherent Tanzanians with CPD.Muhimbili National Hospital and ambulatory clinics in Dar es Salaam, Tanzania.100 Tanzanians with CPDs and suboptimal medication adherence were dichotomized into low and moderate-to-high risk alcohol use based on AUDIT scores and compared regarding medication attitudes, adherence and psychiatric symptoms. Patients completed the ASSIST for comparison to AUDIT risk stratification.Moderate-to-high risk alcohol users had worse medication attitudes ( < 0.01), medication adherence (previous week, = 0.01; previous month, < 0.001), and psychiatric symptoms ( = 0.03). They were younger, predominately male and more likely to have a family history of alcohol abuse. A logistic regression analysis found age, gender and family history of abuse as significant predictors of hazardous alcohol use ( = 0.02, 0.02, < 0.01, respectively). Risk stratification between AUDIT and ASSIST aligned in 85% of participants.Alcohol use is an important consideration in treating poorly adherent Tanzanians with CPD. The ASSIST was comparable to the AUDIT in stratifying risky alcohol use with the additional benefit of screening for other substances.

Authors & Co-authors:  Simon Emily E Levin Jennifer B JB Mbwambo Jessie J Blixen Carol C Lema Isaac I Aebi Michelle M Njiro Godwin G Cassidy Kristin K Kaaya Sylvia S Sajatovic Martha M

Study Outcome 

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Citations :  Almond S, Knapp M, Francois C, Toumi M, Brugha T. Relapse in schizophrenia: Costs, clinical outcomes and quality of life. Br J Psychiatry. 2004;184(4):346–351. 10.1192/bjp.184.4.346
Authors :  10
Identifiers
Doi : 1570
SSN : 1608-9685
Study Population
Male
Mesh Terms
Other Terms
ASSIST;AUDIT;alcohol abuse;chronic psychotic disorders;medication adherence;schizophrenia;sub-Saharan Africa;substance abuse;treatment adherence
Study Design
Study Approach
Country of Study
Tanzania
Publication Country
South Africa