Medication nonadherence among South American patients with schizophrenia

Abstract

ObjectiveThe objective of this research was to quantify nonadherence to medication and explore the determinants of nonadherence in patients diagnosed with schizophrenia (SZ) from three countries in Latin America (Bolivia, Peru, and Chile).MethodsThis study was conducted in public mental health centers in Bolivia, Peru, and Chile. The data collected included drug attitude inventory (DAI-10), sociodemographic information, and clinical and treatment characteristics of patients with SZ. Multivariate analysis with multiple linear regression was then performed to identify variables that were potentially associated with the DAI score (dependent variable).ResultsTwo hundred and fifty-three patients diagnosed with SZ participated in the study and 247 fully completed the DAI-10. In the multivariate analysis, medication nonadherence was associated with being a woman (β=−0.16, p=0.029), younger age (β=0.17, p=0.020), younger age at onset of disease (β=−0.17, p=0.019), and lower insight (β=−0.30, p<0.001).ConclusionBeing a female, younger age, younger age at onset of disease, and lower insight were the main features associated with nonadherence. If future longitudinal studies confirm these findings, these factors should not be neglected in Latin American mental health public policies to address the problem of nonadherence.

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

“…There are several moderating factors for poor attitude towards medication. The moderating factors were younger age [5, 8], male in sex [5, 19], being employed [20–22], urban residence, and living alone, which have a negative relationship with attitude towards medication [22]. Poor attitude towards antipsychotic medication was more common among patients with schizophrenia with a shorter duration of illness (less than five years) [8, 21, 23, 24], later age at onset of illness [25], and having frequent psychiatric hospital admissions [26].…”

<p>Adherence to Antipsychotic Medication and Quality of Life in Latin-American Patients Diagnosed with Schizophrenia</p>

“… 10 However, a previous study (part of the larger International Research Project) showed a difference between the countries involved in this research where patients in Chile reported greater adherence to medication. 13 This last point can be explained by the Mental health policies in Chile, where there is a program Garantías Explícitas en Salud (GES) (Explicit Health Guarantees) that constitute a set of benefits guaranteed by law for individuals diagnosed with schizophrenia and other disorders, which ensures the delivery of antipsychotic medication to the patient, unlike Peru and Bolivia, where access to medication is not universal for the population of patients diagnosed with schizophrenia. 50…”

“…10,11 Non-adherence is considered a complex phenomenon, which could be influenced by four factors: sociodemographic variables, psychotic symptomatology (including persecutory delusion, hostility, and cognitive impairment), variables related to treatment (frequency and intensity of side effects, subjective feeling under treatment, comorbid addiction, duration of treatment, and addictive behavior), and insight into the disorder. [12][13][14][15] Quality of life (QoL) is severely impaired in patients diagnosed with schizophrenia. 16 QoL and adherence to antipsychotics in patients have been studied extensively and independently.…”

“…9,24 Most of this research has been carried out in industrialized countries, but little is known about countries where health resources are scarce and important mental health inequalities exist, such as in Latin-American countries. 13 The objective of this study was to assess the associations between poor adherence and impaired QoL in community-dwelling outpatients diagnosed with schizophrenia in three Latin American countries: Peru, Bolivia, and Chile.…”

“…9 , 24 Most of this research has been carried out in industrialized countries, but little is known about countries where health resources are scarce and important mental health inequalities exist, such as in Latin-American countries. 13 …”