Psychotropic Medication Non-Adherence among Psychiatric Patients at Two Hospitals in Eastern Ethiopia
Background: Major psychiatric disorders have significant contributions to the global burden of disease. The pharmacological management of major psychiatric disorders is mainly challenged by patients’ lack of adherence to their medication. Although it may be well studied in the developed world, it is not well documented in less developed countries, including Ethiopia. Therefore, the aim of this study was to assess the prevalence of psychotropic medication non-adherence and its associated factors among psychiatric patients at two selected hospitals in eastern Ethiopia. Methods: A hospital-based cross-sectional quantitative study was conducted at Hiwot Fana Specialized University Hospital and Dil Chora Hospital from May to June, 2015. A systematic sampling method was applied to recruit 660 adult patients (18 years and older) with major psychiatric disorders at two selected hospitals in the eastern Ethiopia. The patients’ psychotropic medication non-adherence, attitude towards medication, perceived stigma and social support were assessed using adapted tools. Collected data were entered into EpiData version 3.5.3 and then exported to Statistical Package for social sciences (SPSS) version 20.0 for analysis. Descriptive and logistic regression analysis were carried out. Statistical association was declared using adjusted odds ratio (AOR) at 95% confidence interval (CI) and p< 0.05. Results: The prevalence of psychotropic medication non-adherence was 61.2% (95% CI: 57.3-65.0%). Being female (AOR=2.3; 95% CI: 1.4-3.8); taking low potency typical antipsychotic with antidepressants concomitantly (AOR=2.7; 95% CI:1.0-6.9); being on treatment from 6 to 24 months (AOR=2.3; 95% CI:1.4,3.8); more than 24 months (AOR=2.5; 95% CI:1.5-4.1); substance use (AOR=2.6; 95% CI;1.7-4.0); perceived stigma (AOR=2.2; 95% CI:1.53.1); patient’s poor attitude towards the medication (AOR=3.0; 95%CI:1.8-5.1), and poor social support (AOR=1.8; 95%CI:1.3-2.7) were the factors associated with psychotropic medications non-adherence. Conclusion: About two-third of the major psychiatric patients were non-adherent to their psychotropic medication. The non-adherence was significantly associated with being female, low potency treatment and concurrently ill, long treatment duration, substance use, perceived stigma, poor attitude towards medications and lack of social support. Therefore, concerned stakeholders should focus on the associated factors in order to improve adherence to psychotropic medication.
Keywords: Psychotropic medication non-adherence, Major psychiatric disorders, Ethiopia