Adherence to Medication Regimen in Patients with Severe and Chronic Psychiatric Disorders: A Qualitative Study

Abstract

Nonadherence to treatment is common in patients with chronic psychiatric disorders. Few studies have been conducted in Iran on lack of adherence to medication regimen in patients with severe psychiatric disorders. The present study was carried out with the purpose of gaining insight into the experiences of patients, their family members, and nurses on the medication adherence in patients with severe and chronic psychiatric disorders in selected hospitals in Ahvaz, Iran. A qualitative content analysis study was used in the study and the participants included 7 nurses, 5 patients, and 4 family members. The patients were being treated in psychiatric wards of the hospitals of Ahvaz, in southern Iran. The results of data analysis revealed three main themes: 1) Intentional abandonment of medications; 2) Catalysts of medication discontinuation (including side effects, asymptomatic periods, lack of knowledge of family members, and cultural shame of medication use); and 3) Consequences of medication discontinuation. According to the findings of the study, cultural attitudes play an important role in adherence to treatment regimen among the patients with chronic psychiatric disorders. It is recommended to arrange different programs to improve the situation with an emphasis on improving the general attitude of society towards mental illnesses and the need for regular use of the medications.

Deciding to discontinue prescribed psychotropic medication: A qualitative study of service users’ experiences

“…2017; Zarea et al . 2016) and loss of faith in the efficacy of medication (Bjornestad et al . 2017; Boath et al .…”

Mental health service users experiences of medication discontinuation: a systematic review of qualitative studies

“…In total fourteen (n=14) articles (Bjornestad et al, 2017;Boath et al, 2004;Bülow et al. 2016;Cappleman et al, 2015;Fu et al, 2019;Gale et al, 2012;Givens et al, 2006;Katz et al, 2019;LeGeyt et al, 2017;Roe et al, 2009;Solomon & Hamilton, 2013;Teferra et al, 2013;Tranulis et al, 2011;Zarea et al, 2016) were included in the review. The studies were conducted between 2004 and 2019 in a variety of countries (UK, Norway, Sweden, Israel, Iran, Ethiopia, Australia, Canada and USA).…”

“…Following application of the CASP, the quality rating of the articles ranged from medium to high and all were included in the subsequent data extraction and analysis (table 1). Seven of the papers scored within the medium range following quality appraisal (5.5 -7.5), (Bülow et al, 2016;Cappleman et al, 2015;Givens et al, 2012;Roe et al, 2009, Salomon andHamilton, 2013;Teferra et al, 2013;Zarea et al, 2016). The range in scoring related to inadequate reporting on research participant relationships such as the researchers not fully examining their own roles with the research or the potential for bias.…”

“…Taking medication was also seen as reinforcing a stigmatised identity (Bülow et al 2016;LeGeyt et al 2017;Roe et al 2009;Tranulis et al, 2011;Zarea et al 2016). Participants reported discontinuing medication in an attempt to reject the 'psychiatric patient' narrative that was assigned to them following their encounters with the mental health services.…”

“…In Bülow et al's ( 2016) study one participant stopped taking medication because of a belief that he did not experience mental distress and therefore did not need medication. Whereas some participants stated that they stopped medication because they had recovered and no longer needed them (Boath et al, 2004;Tranulis et al, 2011;Zarea et al 2016).…”