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Factors associated with antipsychotic non-adherence in patients with schizophrenia

Author(s): Barbara Pajk

Background: Despite the fact that adherence to antipsychotic medications is the cornerstone in the prevention of exacerbation and the relapse of the disease, more than half of patients with schizophrenia are non-adherent to prescribed medications. The purpose of this study was to examine what are the most common factors associated with antipsychotics non-adherence among patients with schizophrenia. Research Methodology: The study included 91 patients (18 to 65 years) with a diagnosis of ICD-10 (F20), hospitalized at the University Psychiatric Clinic in Ljubljana in various forms of treatment. Measures included socio-demographic characteristics, the substance abuse, the number of prescribed medications and daily doses, the knowledge of the prescribed antipsychotic medication, the causes for non-adherence using the Alberta Mental Health Survey questionnaire and attitudes towards drugs using the Drug Attitude Inventory (DAI-10). Adherence was assessed subjectively. Results: 61.5% of patients were non-adherent to antipsychotic medication. There was a negative correlation between medication non-adherence and substance abuse (smoking p=0.013, alcohol p=0.030, drugs p=0.001), negative attitudes towards medication (p=0.012), knowledge of side effects (p=0.009), a higher number of daily doses of antipsychotic medication (p=0.001) and male gender (p=0.003). The most common cause for non-adherence identified was the patient’s belief that they can cure without antipsychotic medications (27.5%) followed by the patient’s subjective feeling that they feel better and therefore the medication would no longer be needed (22.0%), and side effects (16.0%), whereby difficulties with fatigue and weight gain predominated. Subjective feeling that the medication did not help (13.2%); forgetfulness (12.1%) and sexual dysfunction (7.7%) were also identified as a reason for non-adherence. Conclusion: Healthcare professionals should intensely strive to promote adherence among patients with schizophrenia with an emphasis on an individual approach regarding the causes of non-adherence. Special attention should be paid to a vulnerable group of patients.


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