No abstract

Background: In Arab and Muslim-dominated countries, spirituality and religiosity shape the belief and practices toward chronic illnesses. No previous studies were published to assess adherence to and satisfaction with antipsychotic medications in persons with schizophrenia in the Arab world.Objective: To assess medication adherence and treatment satisfaction with antipsychotics in a sample of Palestinian people with schizophrenia.Methodology: Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Psychiatric symptoms were assessed using the expanded Brief Psychiatric Rating Scale (BPRS-E). Data were entered and statistically analyzed using SPSS 16 for windows.Results: A convenience sample of 131 persons with schizophrenia was studied. Based on MMAS-8, 44 persons (33.6%) had a low rate, 58 (44.3%) had a medium rate and 29 (22.1%) had a high rate of adherence. Age was significantly correlated (P=0.028) with adherence score. However, variables like use of monotherapy or atypical or depot antipsychotics were not significantly associated with higher adherence. The means of satisfaction with regard to effectiveness, side effects, convenience and global satisfaction were 72.6 ± 20.5, 67.9 ± 31.47, 63.2 ± 14.3 and 63.1 ± 18.8 respectively. There was a significant difference in the means of effectiveness (P<0.01), convenience (P<0.01), global satisfaction (P<0.01), but not side effects domains (P=0.1) among persons with different levels of adherence. Furthermore, there was a significant difference in the means of positive symptom score (P<0.01), manic (P<0.01) and depression (P<0.01) but not negative symptom score (P=0.4) among persons with different levels of adherence.Conclusions: Medication nonadherence was common and was associated with low treatment satisfaction scores and poor psychiatric scores. Medication related factors had insignificant effects on adherence scores.

No abstract

The objective of this paper was to study antipsychotic medication use in the outpatient psychiatry department in Palestine. Methodology: This is a cross sectional study carried out in Palestine on schizophrenic patients aged between 20 -65 whose medications have not been changed in the past six months and they did not have an acute attack in the last year. Information regarding antipsychotic medications use was obtained from patients' medical files; patients' psychiatric symptoms were evaluated using the Expanded Brief Psychiatric Rating Scale (BPRS-E).Results: More than half (53.1%) of 150 patients were on antipsychotic polypharmacy (APP) with average daily dose of 546.9 ± 254.9 mg chlorpromazine equivalents. The average number (mean ± SD) of medications a patient received was 1.7 ± 0.7. One third of patients on APP regimen received atypical antipsychotic and all of them received at least one conventional antipsychotic. Factors significantly and positively associated with APP were: use of anticholinergic agents (P<0.001), conventional antipsychotics (P<0.001), depot formulations (P<0.001) and prescribing higher doses of antipsychotics (P<0.001). Discussion and Conclusion: Antipsychotic polypharmacy in this study was common. Adherence to international guidelines in the treatment of schizophrenia is recommended.