Antipsychotic medication non-adherence and its determinants among out-patients with schizophrenia.

Journal: Malawi medical journal : the journal of Medical Association of Malawi

Volume: 36

Issue: 4

Year of Publication: 2025

Affiliated Institutions:  Irrua Specialist Teaching Hospital Ringgold standard institution - Department of Psychiatry Irrua, Edo State, Nigeria. Nnamdi Azikiwe University Ringgold standard institution - Department of Mental Health, Nnewi campus, Nnewi, Anambra, Nigeria. Federal Neuro Psychiatric Hospital Ringgold standard institution - Clinical services, Benin City, Edo State, Nigeria. Federal Neuro Psychiatric Hospital Ringgold standard institution - clinical services Benin City, Edo State, Nigeria. Federal Neuro Psychiatric Hospital Ringgold standard institution - clinical services, Benin City, Edo State, Nigeria. Edo State University Uzairue Ringgold standard institution - Department of Radiology, Iyamho, Edo State, Nigeria. Federal Medical Centre Asaba Ringgold standard institution - psychiatry, Asaba, Delta State, Nigeria. Nnamdi Azikiwe University Ringgold standard institution - Department of Mental Health, Nnewi Campus, Nnewi, Anambra, Nigeria.

Abstract summary 

While antipsychotics are key requirement in acute and long-term management of schizophrenia, medication adherence remains a major unmet need in its care. This paper assessed the prevalence of oral antipsychotic non-adherence among outpatients with schizophrenia and its associated clinico-demographic factors.Three hundred and ten adult outpatients (18-64 years of age) were cross-sectionally interviewed after being diagnosed of schizophrenia using ICD-10 criteria, and the diagnosis confirmed with the Mini International Neuropsychiatric Interview (MINI). The socio-demographic questionnaire, Morisky Medication Adherence scale (MMAS-8), Brief Psychiatric Rating Scale (BPRS), Liverpool University Neuroleptic Side Effects Scale (LUNSERS), Drug Attitude Inventory (DAI-10), Scale to Assess Unawareness of Mental Disorders (SUMD) were used to obtain participants' demographic profile, level of medication adherence, illness severity, attitude towards antipsychotics, and level of insight respectively.At least one in every two outpatients with schizophrenia (n=158; 51.0%) did not adhere to their antipsychotics as prescribed. The independent risk factors for poor oral antipsychotic adherence were illness severity (p= 0.001; AOR 1.13), psychoactive substance use (p= 0.009; AOR 1.87), young age (p= 0.014; AOR 2.09), perceived poor social support (p= 0.025; AOR 3.58), use of first generation antipsychotics alone (p= 0.006; AOR 17.99), use of second generation antipsychotics alone (p= 0.02; AOR 29.36), and awareness of symptoms (p= 0.025; AOR 1.18).The high rate of poor medication adherence should necessitate much emphasis on the highlighted modifiable risk factors and the need for continuous adherence assessments and education in clinical practice.

Authors & Co-authors:  Erohubie Paul P Oriji Sunday S Olotu Sunday S Agbonile Imafidon I Anozie Ihechiluru I Erohubie Omigie O Enebe Anthony A Onu Justus J

Study Outcome 

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Statistics
Citations :  WHO, author. Schizophrenia [Internet] 2023. Mar 6, Available from: https://www.who.int/news-room/fact-sheets/detail/schizophrenia .
Authors :  8
Identifiers
Doi : 10.4314/mmj.v36i4.8
SSN : 1995-7270
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Antipsychotics;Nigeria;adherence;determinants;schizophrenia
Study Design
Study Approach
Country of Study
Publication Country
Malawi