Psychotropic medication adherence and associated personality traits in Uganda: a hospital based cross-sectional study

Abstract

Background: Psychiatric disorders like other chronic disorders need medications both in short and in long-term treatment. Medication adherence is the first and main determinant of treatment success. Non-adherence to psychiatric drugs is associated with relapse, rehospitalisation and premature death. The beliefs about medication which influence non-adherence to medications are moderated by specific personality traits. Non-adherence to psychotropic medications is high in Africa but there is paucity of published studies on the level of psychotropic medication adherence and associated personality traits in Uganda. Aim: To determine the prevalence of psychotropic medication adherence and associated personality traits among people with mental illness attending Kampala International University Teaching Hospital and Jinja Regional Referral hospital. Methods: A Hospital based cross-sectional design was used in this study. 396 adult patients with mental illness were recruited from outpatient clinics of Kampala International University-Teaching Hospital and Jinja Regional Referral Hospital. Medication adherence was assessed using Medication Adherence Rating Scale (MARS) while personality traits were assessed by the short form of Big Five Inventory (Ten Items Personality Inventory). We first determined other possible factors (confounders) that could influence medication adherence before reaching to the objective of the study. Logistic regression was used to assess personality traits and other factors associated with psychotropic medication adherence. Results: The majority of the study participants were males 234(59.1%), from rural areas (74.2%), with secondary educational level (47.5%) and unemployed (44.9%). 53.8% of patients were adherent to psychotropic medications. The personality traits significantly associated with psychotropic medication adherence were neuroticism (aOR=0.84, CI=0.812-0.881, P<0.001) and agreeableness (aOR=1.11, CI=1.080-1.145, P<0.001). Others factors associated with psychotropic medications adherence included poor family support (aOR=0.145, CI=0.077-0.272, P<0.001), belief in witchcraft (aOR=0.338, CI=0.170-0.672, P=0.002), presence of side effects (aOR=0.443, CI=0.260-0.754, P=0.003) and substances use (aOR=0.240, CI=0.122-0.471, P<0.001). Conclusion: The prevalence of medication adherence was low. Patients with neuroticism personality traits were less likely to be adherent to medications and patients with agreeableness trait were more likely to be adherent to medications. Reinforced psychoeducation about mental illness and medication adherence to specific population such as patients with neuroticism personality traits and those with alcohol and other substances use would help to improve adherence to medication in Uganda.