Medication adherence among Nigerians with schizophrenia: correlation between clinico-demographic factors and quality of life

Abstract

Medication adherence contributes significantly to symptom remission, recovery and wellbeing in mental illnesses. We evaluated how medication adherence correlates with clinico-demographic factors and quality of life (QoL) in a sample of Nigerians with schizophrenia. This descriptive cross-sectional study involved 160 randomly selected participants with confirmed diagnosis of schizophrenia based on MINI International Neuropsychiatric Interview. Data on socio-demographic and clinical characteristics of participants were collected with a questionnaire. Medication adherence was assessed with Morisky Medication Adherence Questionnaire, and participants completed the World Health Organization Quality of Life Scale-BREF. The mean age of participants was 38.54 (±11.30) years, and all the participants were on antipsychotics, but only 45% were adherent to their medication. Out of all the participants, 45 (28.2%) considered their overall QoL to be good, 97 (60.6%) considered theirs to be fair, while 18 (11.2%) reported poor QoL. Medication non-adherence correlated negatively with good QoL across multiple dimensions including overall QoL (r=-0.175), health satisfaction (r=-0.161), physical (r=-0.186) and psychological domain (r=-0.175). Again, participant’s age (r=-0.190) and age of onset of illness (r=-0.172) correlated negatively with medication non-adherence, and a trend towards relapse delay with medication adherence was also observed (r=-0.155). The effect size of these correlations were however small. Our findings suggest a link between medication adherence and QoL in schizophrenia, such that strategy that addresses medication non-adherence and its determinants may have potential benefits on wellbeing. Further hypotheses-driven studies are desirable.

Quality of life and its association with current substance use, medication non-adherence and clinical factors of people with schizophrenia in Southwest Ethiopia: a hospital-based cross-sectional study

“…The lowest score on the social relationship domain of QoL among people with schizophrenia in our study could be due to the negative symptoms, which affect the patient's ability to live independently, to perform activities of daily living, to be socially active and maintain personal relationships. Also, it could be due to the stigma towards mental illness, which excludes the mentally ill from social life (21). In the current study, medication non-adherence was significantly and negatively associated with all domains of quality of life and with the overall quality of life, and this result was in line with the previous study [20].…”

“…Also, another study done in Nigeria found that there are significant negative correlations between the overall health satisfaction, physical and psychological domains of quality of life and medication adherence: i.e. participants with poorer medication adherence were more likely to have poorer mean scores on the overall QoL, health satisfaction, physical and psychological domains [21].…”

Comparative assessment of quality of life of patients with schizophrenia attending a community psychiatric centre and a psychiatric hospital

“…Studies looking at the association between clinical variables and QoL have reported a significant association between the number of daily medication, the presence of anxiety/depression symptoms, suicidality, comorbid medical problems and general psychopathology7–9,34,35,36 and medication adherence 9,37. According to Akinsulore et al, the presence of depressive symptoms, negative and positive symptoms of schizophrenia and frequency of relapse also predicts greater disability in patients with schizophrenia 36…”

Effective strategies for nurses empowering the life quality and antipsychotic adherence of patients with schizophrenia

“…Whereas some studies have attempted to measure the relationship between the life quality with medication adherence in clients with schizophrenia and even the results of such studies provide overturning results as those of a recent study conducted by Ogunnubi et al [31] who reported that participants with poorer drug adherence were more likely to have poorer mean scores on an overall the life quality, physical health, satisfaction and psychological WHO QoL scale. In this respect, Dilla, Ciudad and Álvarez [32] who explained non-adherence can aggravate patients' occupational and social functioning, resulting in decreased the quality of life and increased use of health care resources of the society.…”