Some factors affecting drug adherence in patients with schizophrenia

Abstract

Background: Schizophrenia is a chronic mental illness manifested by changes in many mental functions, such as thinking, feeling, and courage. Schizophrenia affects one in every 300 people worldwide and accounts for 50% of psychiatric hospitalizations. In our country, there are n=1283 patients under the outpatient supervision of the National Center For Mental Health, which is 18.9% of the total number of patients. In the conditions of our country, some studies have been conducted on the side effects of psychoactive drugs, but the adherence to the drug treatment regimen and the factors affecting it have not been sufÏciently studied, which is the reason for conducting this study. Aim: To study the adherence to medication regimens and some influencing factors of patients with schizophrenia. Materials and Methods: The study was conducted using a descriptive moment model, random sampling method, and a questionnaire survey from March 2023 to August 2023, based on ambulatory and clinics of the National Center for Mental Health. Ethical permission to conduct research was discussed and ethical permission was obtained on (03-02-2023) at the meeting of the Research Ethics Control Committee of MNUMS on February 17th, 2023, and the permission was obtained from the medical personnel through the consent form and attached to the research card. The results of the study were analyzed using Microsoft Word, Microsoft Excel, and STATA 14 software. Results: A total of 209 schizophrenic patients aged 18-79 participated in the study, 47.4% (n=99) were male, 52.6% (n=110) were female, and the gender ratio was (1:1.1). The average age of the patients with schizophrenia in the study was 23.5±7 (11-48 years), the average number of years under medical supervision was 21.04±13.2 (1-58 years), and the average duration of the disease was 21.04±13.2 (1-58 years). When evaluating the adherence to medication regimen of patients with schizophrenia by Morsky’s test, 1.5% (n=3) had good adherence, 52.6% (n=110) had moderate adherence, and 45.9% (n=96) had poor adherence to medication regimen (Cronbach’s α=0.781). When examining some treatment-related influencing factors in comparison with adherence to medication regimens, 61.7% (n=129; p=0.001) think that taking medication often is harmful to the body, and 32.1% (n=67; p=0.000) think that taking medication most of the time forget, there was a statistically significant relationship between who to ask for advice on medication use (p=0.001), while 13.9% (n=29) found it difÏcult to take medication multiple times a day, 15.3% (n=32) are embarrassed by others because side effects are obvious, 49.8% (n=104) are difÏcult for themselves because of side effects of drugs, 32.1% (n=67) cannot buy drugs due to lack of money answered and there was not related to treatment adherence. Conclusion: 98.5% of schizophrenic patients surveyed had moderate to poor adherence to medication regimens. It is hypothesized that the support of family members has a positive effect on adherence to medication regimens, while the fact that patients think frequent medication is harmful to the body has a negative effect on adherence to medication regimens.