Attitude towards Antipsychotic Medications in Patients Diagnosed with Schizophrenia: A Cross-Sectional Study at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Abstract

Background. Poor attitude towards antipsychotic drugs is high, and it is a factor for non-adherence to treatment. This increases the risk of relapse, associated healthcare utilization, and costs. This study aimed to assess attitude towards antipsychotic medication among patients with schizophrenia. Objectives. The aim of this institution based cross-sectional study was to assess attitude towards antipsychotic medications and associated factors among patients with schizophrenia who attend the outpatient clinics at Amanuel Mental Specialized Hospital, 2018. Methods. In a cross-sectional study, 393 schizophrenic patients from Amanuel Mental Specialized Hospital were recruited by a systematic random sampling technique. Drug Attitude Inventory (DAI-10) was used to assess attitude, experience, and belief about antipsychotics. Glasgow antipsychotic side effect scale modified version, positive and negative syndrome scale, and Birch wood’s insight scale for psychosis were the instruments used to assess the associated factors. Simple and multiple linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% confidence interval was used. Results. The mean score of attitude towards antipsychotic medications was 6.51 with standard deviation (SD) of 2.22. In multiple linear regression, positive symptoms (β= -0.07, 95% CI: (-0.09, -0.05)), negative symptoms (β= -0.04, 95% CI: (-0.06,-0.02)), shorter (≤5 years) duration of illness (β= -0.39, 95% CI: (-0.63, -0.15)), first generation antipsychotics (β = -0.35, 95% CI: (-0.55,-0.14)), having sedation (β= -0.28, 95% CI: (-0.52, -0.02)), and extra-pyramidal side effects (β= -0.34, 95% CI: (-0.59,-0.09)) were factors negatively associated with attitude towards antipsychotic medication treatment. Insight to illness (β= 0.24, 95% CI: (0.20, 0.27) was a factor positively associated with attitude towards antipsychotic medications. Conclusion. The result suggests that the mean score of participants’ attitude towards antipsychotic medications was good. Prevention of side effects particularly due to first generation antipsychotics is necessary.

Attitude and preferences towards oral and long-acting injectable antipsychotics in patients with psychosis in KwaZulu-Natal, South Africa

“…The current study failed to find an association between drug attitude score and history of rehospitalisation due to treatment discontinuation or number of admissions. This is not consistent with the literature, 47 , 55 as previous studies suggest that patients with a poorer drug attitude score are at increased risk of poorer drug adherence and hence poorer DAI scores were associated with increased relapse and readmission. The lack of association in this study may be due to biased reporting by participants, thus inflating DAI scores, small sample size or sample selection bias as participants were all on treatment, currently adherent and hospitalised in the past six months.…”

A scoping review: Treatment attitudes and adherence for adults with schizophrenia

“…They found that people with awareness of illness and the ability to recognise symptoms had positive treatment attitudes, which was significantly associated with adherence (Eticha et al, 2015;Kassew et al, 2019). Furthermore, insight of illness was a factor positively associated with attitude towards antipsychotic medications (Kassew et al, 2019).…”

“…Insight into illness (Baloush-Kleinman et al, 2011;Beck et al, 2011;Eticha et al, 2015;Kassew et al, 2019;Vassileva et al, 2014;Yalamova, 2015) Quality of life (Vassileva et al, 2014) Unawareness of mental disorders (Baloush-Kleinman et al, 2011;Beck et al, 2011) Subjective well-being (Widschwendter et al, 2018) Attitudes towards medication (Baloush-Kleinman et al, 2011;Campbell et al, 2018;Kassew et al, 2019;Vassileva et al, 2014;Widschwendter et al, 2018;Yalamova, 2015) Psychosocial function (Brain et al, 2013;Kondrátová et al, 2019;Vassileva et al, 2014;Widschwendter et al, 2018) Medication adherence (Baloush-Kleinman et al, 2011;Beck et al, 2011;Brain et al, 2013;Campbell et al, 2018;Eticha et al, 2015;Vassileva et al, 2014;Yalamova, 2015) Severity of side effects/ side effects (Baloush-Kleinman et al, 2011;Eticha et al, 2015;Kassew et al, 2019;Vassileva et al, 2014;Widschwendter et al, 2018;Yalamova, 2015) Experience and beliefs about antipsychotics/ beliefs about treatment (Brain et al, 2013;Eticha et al, 2015) Perceived illness (Baloush-Kleinman et al, 2011) Cognition (Campbell et al, 2018) Severity of psychopathology/ severity of the ...…”

“…Beck et al (2011) commented that the decision to seek and remain on treatment for people experiencing schizophrenia starts with awareness followed by realisation for the need for treatment and finally acceptance of treatment. Two studies conducted in Ethiopia investigated factors associated with medication adherence among adults experiencing schizophrenia (Eticha et al, 2015;Kassew et al, 2019).…”

Adherence to Pharmacological Treatment Among Patients with Schizophrenia

“…9 Thus, antipsychotic agents enhance recovery through the control of symptoms, improve quality of life, restore basic life functioning, and prevent relapse. 10 A significant component in treatment is enhancing the quality of life through successful jobs and relationships and not just reducing the signs and symptoms. 9 Antipsychotic medication alone is insufficient to address the complex social, financial, and health needs of patients with schizophrenia.…”