Impact of adverse reactions to first-generation antipsychotics on treatment adherence in outpatients with schizophrenia: a cross-sectional study

Abstract

Background Antipsychotics are well-known to cause potentially serious and life-threatening adverse drug reactions (ADRs) that have been reported to be also one of the major reasons for non-adherence. In Eritrea, shortage of psychiatrists and physicians, inadequacy of laboratory setups and unavailability of second-generation antipsychotics in the national list of medicines would seem to amplify the problem. This study’s objective is to determine the impact of adverse effects of first-generation antipsychotics on treatment adherence in outpatients with schizophrenia at Saint Mary Neuro-Psychiatric National Referral Hospital. Methods A cross-sectional study design was employed. All eligible adult patients with diagnosed schizophrenia (n = 242) who visited the hospital during the study period were enrolled. Data on ADRs, adherence and other variables were collected from patients using a self-administered questionnaire, interview and through medical cards review. The collected variables were analyzed using SPSS 22.0 with descriptive and multivariable logistic regression analysis. Statistical significance was tested at p value < 0.05. Results Greater than one-third (35.5%) of the patients with schizophrenia were non-adherent to treatment. The odds of non-adherence increased 1.06 times for each unit increase in the total ADR score (AOR = 1.06, 95% CI 1.04, 1.09). Patients with extrapyramidal (AOR = 44.69, 95% CI 5.98, 334.30), psychic (AOR = 14.90, 95% CI 1.90, 116.86), hormonal (AOR = 2.60, 95% CI 1.41, 4.80), autonomic (AOR = 3.23, 95% CI 1.37, 7.57) and miscellaneous reactions (AOR = 2.16, 95% CI 1.13, 4.13) were more likely to be non-adherent compared to their counterparts. Conclusion Poor treatment adherence was found to be substantial which was attributed to total ADR score, extrapyramidal, hormonal, psychic, autonomic and miscellaneous categories of reactions of the LUNSERS. To improve treatment adherence, early detection and management of adverse effects and inclusion of second-generation antipsychotics are recommended.

The effect of medication adherence on psychosocial adjustment to body weight, image, and self‐esteem in patients with schizophrenia

“…In other studies conducted in Turkey, poor medication adherence of patients with schizophrenia ranged from 27.3% to 80% (Ata et al, 2019; Kalkan & Kavak‐Budak, 2020; Yılmaz & Okanlı, 2015). Medication nonadherence of patients with schizophrenia was 65.5% in Nigeria, 50.0% in France, 35.5% in Eritrea, and 34.1%–35% in India (Bahta et al, 2021; Lama & Baruah, 2019; Nwoga et al, 2017; Shakeel et al, 2017; Tessier et al, 2017). Sociodemographic factors, such as self‐efficacy, quality of life, social functioning, insight, religion, side effects, type of antipsychotics, social support from significant others, and nurse–patient relationships, can affect medication adherence of patients with schizophrenia (Tham et al, 2018; Yu et al, 2021).…”

Psychosocial, Internal and External Factors of Treatment Compliance of Schizophrenic Patients: A Literature Review

“…The side effects that arise are often the reason for non-compliance to treatment undertaken by people with schizophrenia, extrapyramidal syndrome effects, hormonal effects, psychological effects on mood changes or other categories of reactions (Bahta et al, 2021). Side effects of treatment will also increase along with the multiple treatments that have been undertaken, patients who receive monotherapy or one type of drug are more often completely adhered to than those who receive different drug combinations, (Both et al, 2021).…”

Factors Affecting Medication Adherence Among patient with Schizophrenia: A Literature Review

“…The side effects that arise are often the reason for non-adherencee to treatment undertaken by people with schizophrenia, extrapyramidal syndrome effects, hormonal effects, psychological effects on mood changes or other categories of reactions (Bahta et al, 2021). Side effects of treatment will also increase along with the multiple treatments that have been undertaken, patients who receive monotherapy or one type of drug are more often completely adhered to than those who receive different drug combinations, (Both et al, 2021).…”