Document Type : Original Article
Authors
- . Jonathan Danladi 1
- . Kakjing D. Falang 2
- . Raymond A. Barde 1
- . Nanlok S. Jimam 3
- . Dauda A. Dangiwa 3
- . Hafsat O. Jimoh 1
1 Department of Pharmacy, Jos University Teaching Hospital, Jos, Nigeria
2 Department of Pharmacology, University of Jos, Plateau State, Nigeria
3 Department of Clinical Pharmacy, University of Jos, Plateau State, Nigeria
Abstract
Objective: The primary objective of this study is to examine the medication adherence
levels (as a function of pharmaceutical care) and its contributing factors in schizophrenic
patients receiving antipsychotic drugs.
Methods: This was a cross-sectional study administering a structured questionnaire to
231 patients. Adherence was measured through patient self-reporting. Association between
independent variables and adherence to antipsychotics were measured through odds ratios
(OR) in the univariate analysis while the best predictors of adherence were determined
through the multiple logistic regressions.
Findings: Adherence level was found to be 65.8% (95% confidence interval [CI]: 59.3-71.9%).
The following factors were identified to be associated with adherence in the univariate
analysis: age (OR 1.088), sex (OR 1.231), employment (OR 0.366), marital status (singles, OR
0.022), drug adherence counseling (OR 11.641), twice a day frequency (OR 8.434), alcohol
non-intake (OR 1.469), educational level (primary OR 1.9312, secondary OR 11.022, tertiary
OR 4.771), occupation (public servant 6.273). In the multivariate analysis, age, three times
a day frequency of drug intake, singles and educational levels such as primary, secondary or
tertiary school, strongly affected adherence (P < 0.05).
Conclusion: Although patients adherence level was high (65.8%), there is a need to
emphasize that pharmacists spend more time in counseling and educating patients, especially
younger ones on drug adherence before any antipsychotic medications are dispensed.
Furthermore, patients should be taught the use of adherence devices such as reminders so
that adherence to antipsychotic medications can be optimized.
Keywords
- World Health Organization. The Global Burden of Disease: 2004
Update. Geneva, Switzerland: World Health Organization;
2008. Available from: http://www.who.int/healthinfo/global_
burden_disease/GDB_report_2004updat_fullpdf. [Last
accessed on 2013 Apr 5].
2. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL,
et al. Comorbidity of mental disorders with alcohol and other
drug abuse. Results from the epidemiologic catchment area
(ECA) study. JAMA 1990;264:2511-8.
3. Adewuya AO, Makanjuola RO. Lay beliefs regarding causes of
mental illness in Nigeria: Pattern and correlates. Soc Psychiatry
Psychiatr Epidemiol 2008;43:336-41.
4. Hepler CD, Strand LM. Opportunities and responsibilities in
pharmaceutical care. Am J Hosp Pharm 1990;47:533-43.
5. Coons SJ, Johnson JA. Humanistic outcomes. In: Smith MC,
Wertheiner AI, editors. Social and Behavioural Aspects of
Pharmaceutical Care. New York: Pharmaceutical Products;
1996. p. 403-45.
6. Kucukarslan S, Schommer JC. Patients’ expectations and their
satisfaction with pharmacy services. JAm Pharm Assoc (Wash)
2002;42:489-95.
7. Brodie DC, Parish PA, Poston JW. Societal needs for drugs and
drug-related services. Am J Pharm Educ 1980;44:276-8.
8. Adewuya AO, Owoeye OA, Erinfolami AR, Coker AO, Ogun
OC, Okewole AO, et al. Prevalence and correlates of poor
medication adherence amongst psychiatric outpatients in
Southwestern Nigeria. Gen Hosp Psychiatry 2009;31:167-74.
9. Rettenbacher MA, Hofer A, Eder U, Hummer M, Kemmler G,
Weiss EM, et al. Compliance in schizophrenia: Psychopathology,
side effects, and patients’ attitudes toward the illness and
medication. J Clin Psychiatry 2004;65:1211-8.
10. Taira M, Hashimoto T, Takamatsu T, Maeda K. Subjective response to neuroleptics: The effect of a questionnaire about
neuroleptic side effects. Prog Neuropsychopharmacol Biol
Psychiatry 2006;30:1139-42.
11. Beck EM, Cavelti M, Wirtz M, Kossowsky J, Vauth R. How do
socio-demographic and clinical factors interact with adherence
attitude profiles in schizophrenia? A cluster-analytical
approach. Psychiatry Res 2011;187:55-61.
12. Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV.
Prevalence of and risk factors for medication non-adherence
in patients with schizophrenia: A comprehensive review of
recent literature. J Clin Psychiatry 2002;63:892-909.
13. Deegan PE, Drake RE. Shared decision making and medication
management in the recovery process. Psychiatr Serv
2006;57:1636-9 - 14. Hamann J, Kruse J, Schmitz FS, Kissling W, Pajonk FG.
Patient participation in antipsychotic drug choice decisions.
Psychiatry Res 2010;178:63-7.
15. Falang KD, Akubaka P, Jimam NS. Patient factors impacting
antiretroviral drug adherence in a Nigerian tertiary hospital.
J Pharmacol Pharmacother 2012;3:138-42.
)