Psychotropic medication non-adherence and its determinants among adult psychiatric patients in Ethiopia.
Mental illness remains a significant global public health concern, yet it is largely manageable through psychotropic medications and psychotherapy. However, non-adherence to prescribed psychotropic medications is a major barrier to effective treatment and long-term symptom control. This challenge compromises clinical outcomes, increases relapse rates, and places a burden on healthcare systems. Understanding the extent and contributing factors of medication non-adherence is essential for designing targeted interventions at both clinical and community levels. This study aims to assess the prevalence of psychotropic medication non-adherence and identify its determinants among adult psychiatric patients in Ethiopia.
An institution-based cross-sectional study was carried out between November 1 to November 30, 2024, among adult psychiatric outpatients who were diagnosed according to DSM-5-TR criteria and were receiving psychotropic treatment. Participants were selected using a consecutive sampling technique. Medication non-adherence was assessed using the 10-item Medication Adherence Rating Scale (MARS). Data were collected through face-to-face interviews and review of medical records. Bi-variable and multivariable binary logistic regression analyses were performed to identify associated factors, with statistical significance set at p-value < 0.05.
Out of a total of 418 participants, the prevalence of psychotropic medication non-adherence was 44.7% (95% CI: 40.0-50.0). Factors significantly associated with non-adherence included experiencing medication side effects (AOR = 4.67, 95% CI: 2.68-8.16), Lack of enrollment in the Community-Based Health Insurance scheme (AOR = 2.41, 95% CI: 1.06-5.5), current substance use (AOR = 6.71, 95% CI: 2.01-22.36), presence of comorbid medical illness (AOR = 5.42, 95% CI: 1.79-16.4), and perceived stigma (AOR = 3.63, 95% CI: 1.91-6.87).
Nearly half of the adult psychiatric outpatients in this study were non-adherent to psychotropic medications. Key factors associated with non-adherence included medication side effects, Lack of enrollment in the Community-Based Health Insurance scheme, current substance use, comorbid medical conditions, and perceived stigma. These findings highlight the need for integrated interventions addressing both clinical and psychosocial barriers to improve medication adherence and treatment outcomes among psychiatric patients in Ethiopia. Targeted strategies should be implemented at both healthcare facility and community levels.
An institution-based cross-sectional study was carried out between November 1 to November 30, 2024, among adult psychiatric outpatients who were diagnosed according to DSM-5-TR criteria and were receiving psychotropic treatment. Participants were selected using a consecutive sampling technique. Medication non-adherence was assessed using the 10-item Medication Adherence Rating Scale (MARS). Data were collected through face-to-face interviews and review of medical records. Bi-variable and multivariable binary logistic regression analyses were performed to identify associated factors, with statistical significance set at p-value < 0.05.
Out of a total of 418 participants, the prevalence of psychotropic medication non-adherence was 44.7% (95% CI: 40.0-50.0). Factors significantly associated with non-adherence included experiencing medication side effects (AOR = 4.67, 95% CI: 2.68-8.16), Lack of enrollment in the Community-Based Health Insurance scheme (AOR = 2.41, 95% CI: 1.06-5.5), current substance use (AOR = 6.71, 95% CI: 2.01-22.36), presence of comorbid medical illness (AOR = 5.42, 95% CI: 1.79-16.4), and perceived stigma (AOR = 3.63, 95% CI: 1.91-6.87).
Nearly half of the adult psychiatric outpatients in this study were non-adherent to psychotropic medications. Key factors associated with non-adherence included medication side effects, Lack of enrollment in the Community-Based Health Insurance scheme, current substance use, comorbid medical conditions, and perceived stigma. These findings highlight the need for integrated interventions addressing both clinical and psychosocial barriers to improve medication adherence and treatment outcomes among psychiatric patients in Ethiopia. Targeted strategies should be implemented at both healthcare facility and community levels.