Antipsychotic medication non-adherence among schizophrenia patients in Central Ethiopia

Tareke, Minale; Tesfaye, Siranesh; Amare, Desalegn; Belete, Tilahun; Abate, Andargie

doi:10.4102/sajpsychiatry.v24i0.1124

Cited by 25 publications

(28 citation statements)

References 28 publications

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“…Khat chewers were also more likely is could be explained by the reason that chewing khat is associated with loss of appetite [34] and the economic burden of buying khat may not allow them to afford healthy diets. e negative effect of khat chewing on adherence was shown by other studies [35,36]. Social support was also significantly associated with adherence to dietary recommendations (AOR: 2.4, 95% CI [1.42-4.35]).…”

Section: Predictors Of Nonadherence To Dietary Recommendationssupporting

confidence: 51%

Prevalence and Predictors of Nonadherence to Diet and Physical Activity Recommendations among Type 2 Diabetes Patients in Southwest Ethiopia: A Cross-Sectional Study

Negera

Epiphanio

2020

International Journal of Endocrinology

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Background. Nonadherence to lifestyle modification recommendations is a major challenge in the management of diabetes mellitus. This study was conducted to measure the prevalence and predictors of nonadherence to diet and physical activity recommendations among type 2 diabetes patients (T2D). Methods. A cross-sectional study involving 322 type 2 diabetes patients was conducted from April 1 to June 30, 2019. Data were collected through face-to-face interviews using structured and pretested questionnaire. Data on sociodemographic, psychosocial, and clinical characteristics were collected. Descriptive analytical results were reported in text, tables, and figures. Logistic regression was conducted to identify predictors of nonadherence to diet and physical activity. Variables with p value ≤0.25 in bivariate logistic regression were considered as candidates for multivariable regression. Multivariate logistic regression was performed to identify independent predictors. Odds ratios and their 95% confidence intervals together with p value <0.05 were used to declare statistical significance. Result. The rate of nonadherence to physical activity and diet was 64.3% and 36%, respectively. Female gender (AOR: 2.6, 95% CI [1.52–4.56]), age > 60 years (AOR: 2.9, 95% CI [1.12–7.42]), being illiterate (AOR: 4.2, 95% CI [1.86–9.73]), diabetes duration of >5 years (AOR: 2.5, 95% CI [1.42–4.41]), and lack of social support (AOR: 2.4, 95% CI [1.42–4.35]) were independent predictors of nonadherence to physical activity recommendations. Factors associated with nonadherence to dietary recommendations were being male (AOR = 2.8, 95% CI: [1.35–5.65]), age > 60 years (AOR = 6.3, 95% CI: [2.21–18.17]), khat chewing (AOR = 8.0, 95% CI: [3.86–16.7]), lack of social support (AOR = 15.26, 95% CI = [7.45–32.8]), and doctor’s instructions or advice regarding diet (AOR = 8.9, 95% CI = [4.26–18.9]). Conclusion. The rate of nonadherence to diet and physical activity recommendations was high in the study area. Predictors of nonadherence to physical activity are female gender, age > 60 years, being illiterate, diabetes duration of >5 years, and lack of social support. Predictors of nonadherence to diet are being male, khat chewing, lack of social support, and doctor’s instructions or advice regarding diet.

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Section: Predictors Of Nonadherence To Dietary Recommendationssupporting

confidence: 51%

Prevalence and Predictors of Nonadherence to Diet and Physical Activity Recommendations among Type 2 Diabetes Patients in Southwest Ethiopia: A Cross-Sectional Study

Negera

Epiphanio

2020

International Journal of Endocrinology

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“…In this study, one in three of the study participants were found to be non-adherent to their treatment regimens. This is more or less similar to a finding reported in a review of similar studies (40.5%) published in 2002 [5] and other latest studies conducted elsewhere [6,15,29] but lower than some studies reported in Ethiopia (48.4%) [22], Nigeria (51.7%) [16], Kenya (60.4) [21] and Egypt (74%) [30]. On the other hand, lower rates of nonadherence than the present finding were reported in Latin American community-dwelling (19.8%) [31] and northern Ethiopia (26.5%) [17].…”

Section: Discussionsupporting

confidence: 93%

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

et al. 2021

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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.

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“…In a recent study, 62 the non-adherence rate was 41.0% among schizophrenia patients, in which APP was found to increase the risk of non-adherence approximately twice as much compared to those with APM. There have been some debates about whether the number of APs are directly associated with poor adherence, however, a number of studies have clearly indicated that APP is strongly associated with increased risk of diverse SEs leading to poor adherence and persistence.…”

Section: What Concerns Should We Have In the Use Of App In Routine Prmentioning

confidence: 92%

Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

Pae

2020

Chonnam Med J

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Antipsychotics have been utilized as the standard treatment for schizophrenia regardless of illness phase where antipsychotic monotherapy (APM) is routinely recommended as the gold standard rather than antipsychotic polypharmacy (APP). However, approximately 20 to 40% of patients with schizophrenia do not respond to APM based on randomized controlled clinical trials and large practical clinical trials indicating that the subgroup of patients with schizophrenia would need differential treatment approaches beyond traditional treatment strategies such as APM. Numerous studies have supported the use of APP in particular for patients with certain clinical situations including: failure to show efficacy or tolerability from treatment with APM, need for different treatment for targeting specific symptom domains, severe illness, failure to treatment with clozapine, skepticism about following treatment guidelines, or cross titration periods. Furthermore, recent large cohort studies and practical clinical trials have proposed more benefits of APP rather than APM in terms of rehospitalization, mortality, and specific symptoms. APP has recently become more widely utilized and recognized as one of the next treatment strategies to clinicians for patients with schizophrenia. Some experts have already proposed the revision of treatment guidelines incorporating APP as evidence-based treatment option for certain patients with schizophrenia. Taken together, APP now deserves an evidence-based and acceptable treatment strategy, not an empirical or preferential treatment approach for treatment of schizophrenia in contemporary clinical practice.

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Antipsychotic medication non-adherence among schizophrenia patients in Central Ethiopia

Cited by 25 publications

References 28 publications

Prevalence and Predictors of Nonadherence to Diet and Physical Activity Recommendations among Type 2 Diabetes Patients in Southwest Ethiopia: A Cross-Sectional Study

Prevalence and Predictors of Nonadherence to Diet and Physical Activity Recommendations among Type 2 Diabetes Patients in Southwest Ethiopia: A Cross-Sectional Study

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

Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

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