Do Community Free-Medication Service Policy Improve Patient Medication Adherence? A Cross-Sectional Study of Patients With Severe Mental Disorders in Beijing Community

Abstract

Background: Nowadays, mental health problems have become a major concern affecting economic and social development, with severe mental health disorders being the top priority. In 2013, Beijing began to implement the Community Free-Medication Service policy (CFMS). This article aims to evaluate the effect of the policy on medication adherence.Methods: In this study, multi-stage sampling was used to select representative patients as samples. Some of the baseline data were obtained by consulting the archives, and information about patient medication adherence measured by Brooks Medication Adherence Scale was obtained through face-to-face interviews. Logistic regression was used to examine the impact of the policy.Results: Policy participation had a significant positive impact on medication adherence (OR = 1.557). The effect of policy participation on medication adherence in the Medication-only mode and Subsidy-only mode were highly significant, but it was not significant in the Mixed mode.Conclusion: This study found that the CFMS in Beijing as an intervention is effective in improving the medication adherence of community patients. However, the impact of the policy is not consistent among service modes. Reinforcement magnitude and frequency should be considered when designing reinforcement interventions.

Preferences of patients with severe mental disorders in social medical welfare policies: a discrete choice experiment from communities in China

“…In contrast, patients from the "providing subsidy" district consider the reimbursement rate to be the most important factor, similar to the ndings of Chen, et al(2022) [34] and Lv, et al(2020) [35], who have explored demand-side patients' preferences for commercial health insurance, while the reason is that patients in this district mainly use basic health insurance to prescribe medication rather than receiving free medication directly as in the "providing medication" districts. In addition, patients from the "providing medication" districts perceive the relative importance of designated medical institutions to be extremely high because they usually go to the same institutions each month to obtain free medication rather than the self-selection of locations that implement in the "providing subsidy" district [5].…”

“…In 2005, China has introduced a policy for the management and treatment of severe mental illness (also known as the "686" program), which has since been gradually implemented throughout China to provide treatment to patients. A policy of using free medication for the treatment of severe mental disorders (the Community Free-Medication Service policy, CFMS), funded by the Ministry of Finance, has been introduced in the Chinese capital, Beijing, in 2013, decades after the inception of the "686" program [5].…”

Challenges faced when living with schizophrenia in the community: A narrative inquiry

“…Wang et al, 2020; Xiang et al, 2018). Many polices, such as the National Continuing Management and Intervention Program for Psychoses (686 Program) (Good & Good, 2012), 2015-2020 National Mental Health Work Plan (Hua & Zhao, 2015; Xiong & Phillips, 2016), and the Community Free-Medication Service policy (CFMS) (Zhu et al, 2021) enacted and implemented by the government at different levels, have pushed for the improvement of community mental health services, and provided financial assistance to people with mental disorders, such as basic living allowance system, severe illness insurance, and disability certificate (Luo et al, 2018; L. H. Yang et al, 2018).…”

Experiences and challenges faced by community mental health workers when providing care to people with mental illness: a qualitative study

“…Mental health is included in the United Nations 2030 Agenda for Sustainable Development and the World Health Assembly’s extension of the World Health Organization’s (WHO) Action Plan for Comprehensive Mental Health to 2030 [ 5 ]. According to the WHO assessment of disability adjusted life years (DALYs), mental illness is also a major disease burden in China, accounting for about 20.00% [ 6 , 7 ]. Data from the China Mental Health Survey show the lifetime prevalence of any mental illness in the Chinese general population is 16.60% and the 12-month prevalence is 9.30% [ 8 ].…”