scholarly journals Medication compliance in schizophrenic out patients with psychoactive substance use co-morbidity: a cross-sectional study

Author(s):  
Saurabh Ahlawat ◽  
Vikrant Aggarwal ◽  
Rakesh Kumar

Background: Medication adherence is an important issue in the treatment and management of persons with psychiatric disorders including schizophrenia. Apart from side effects and inefficient outcomes of psychiatric medications, substance abuse also complicates the adherence pattern to the prescribed medications. Present study was designed to estimate the magnitude of medication non-adherence and its correlates in patients with schizophrenia having co-morbid psychoactive substance use.Method: The 60 schizophrenic patients with active substance use were taken from OPD of institute of mental health and hospital, Agra. Positive and negative syndrome scale (PANSS), alcohol, smoking and substance involvement screening test (ASSIST), medication adherence rating scale (MARS) and Morisky 8-item medication adherence questionnaire (MMAQ-8) were used to gather relevant clinical data along with a proforma for recording socio-demographic characteristics.Results: The results revealed an alarming level of medication adherence. The 91.7% sample (55 patients) met the criteria for medication non-adherence. Majority of the patients were using alcohol (58.3%) and cannabis (51.7%). Conclusions: Given the high rate of medication non-compliance it is suggested that specific intervention aimed at compliance to prescribed medication is needed in this population.

2016 ◽  
Vol 33 (S1) ◽  
pp. S586-S586
Author(s):  
F. Fatma ◽  
I. Baati ◽  
S. Omri ◽  
R. Sallemi ◽  
J. Masmoudi

IntroductionCompliance is a major issue in the treatment of schizophrenia. Many studies have attempted to identify factors that influence it.ObjectiveTo assess treatment adherence in patients with schizophrenia. To identify factors correlated with poor adherence.MethodsIt was a cross-sectional, descriptive and analytical study, involving 37 outpatients with DSM-IV diagnosis of schizophrenia, followed in the psychiatry department at the Hédi Chaker University Hospital of Sfax (Tunisia). The questionnaire included socio-demographic, clinical and therapeutic data. We also used the Medication Adherence Rating Scale “MARS”, the Insight Scale “IS” and the Stigma Scale (9 items).ResultsThe average age was 36.4 years. The majority of patients was male (68.8%), did not exceed the level of secondary education (89.2%) and had a low socioeconomic level (84.4%).Paranoid schizophrenia was the most frequent type of schizophrenia (54.1%). Atypical antipsychotic were prescribed in 40.5% of cases.Patients were non-adherent to treatment in 56.8% of cases. The factors correlated with poor adherence were: psychoactive substance use (P = 0.036), sexual dysfunction (P = 0.036), complexity of treatment (P = 0.036), poor insight according to the subscale “awareness of the need for treatment” of the IS (P = 0.047) and high score on the subscale “discrimination” of the Stigma Scale (P = 0.008).ConclusionTunisian schizophrenic patients have a poor adherence to treatment. Acting on risk factors (such as substance use, sexual side effects, poor insight and discrimination perception) would improve patient compliance and management of schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2018 ◽  
Vol 29 (2) ◽  
pp. 59-63
Author(s):  
AKM Akramul Haque ◽  
AHM Kazi Mostofa Kamal ◽  
Zinat De Laila ◽  
Luna Laila ◽  
Helal Uddin Ahmed ◽  
...  

Schizophrenia is a chronic psychiatric illness with high rate of relapse which is commonly associated with noncompliance of medicine, as well as stress and high expressed emotions. The objective of the study was to determine the factors of relapse among the schizophrenic patients attending in outpatient departments of three tertiary level psychiatric facilities in Bangladesh. This was a cross sectional study conducted from July, 2001 to June, 2002. Two hundred patients including both relapse and nonrelapse cases of schizophrenia and their key relatives were included by purposive sampling. The results showed no statistically significant difference in terms of relapse with age, sex, religion, residence, occupation and level of education (p>0.05), but statistically significant difference was found with marital status and economic status (p<0.01). The proportion of non-compliance was found to be 80% and 14%, of high expressed emotion was 17% and 2% and of the occurrence of stressful life events was 10% and 1% in relapse and non-relapse cases respectively which were statistically significant (p<0.001). The study indicated that stressful life events, high expressed emotion, and noncompliance with medication had a role in schizophrenic patients for its relapse.Bang J Psychiatry December 2015; 29(2): 59-63


2021 ◽  
Author(s):  
Xiaorong Li ◽  
Xuewen pang ◽  
Fan Zhang

Abstract Backgroud Poor tuberculosis (TB) medication adherence increases the risk of treatment failure and development of drug-resistant TB, while universal implementation of directly observed therapy (DOT) is not feasible in China. EHealth technologies were reported to be promising patient-centered tools for improving adherence. However, only pilot studies have assessed patients’ experiences and the results were discrepant. Methods This cross sectional study study was conducted among TB patients at the outpatient department from 3 March 2019 to 30 May 2020 in Tianjin, China. Data were downloaded from the Tuberculosis doctor App and TB Information Management System (TBIMS), and merged them using the TBIMS notification number. Logistic regression analysis was used to analyze the factors associated with regualar drug-intake. Odds ratios and 95% confident intervals were estimated with and without adjustment for age, gender, ethnicity and occupation. Results A total of 1193 TB patients were recruited, of whom 33.28% (397) patients were regular drug-intake. The whole drug-intake rate was 84.84%, except for the first month, the drug-intake rate decreased with the increase of monthly treatment sequence. After adjustment by age, gender, ethnicity and occupation, tuberculosis pleurisy (aOR: 0.42, 95CI%=0.26-0.69) and retreated patients (aOR: 0.40, 95CI% =0.27-0.59) were more likely to have poor medication compliance. Local resident tend to have better medication compliance (aOR: 1.80, 95CI% =1.16-2.79).Conclusions The medication adherence at the first month should be noticed. Medication adherence was poor in tuberculosis pleuritis and retreated patients, while local resident tend to have better medication adherence. To make full use of the application of eHealth in TB patient management, more incentive measures should be adopted for patients and doctors respectively.


KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 602-609
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Md Faruk Hossain ◽  
Md Waziul Alam Chowdhury ◽  
Anwara Begum

Substance misuse is usually associated with poorer psychiatric medication adherence among mentally ill patients. Identifying proportion & predictors of medication adherence among patients with dual psychiatric and substance misuse problems is important because poor adherence is associated with relapse and re-hospitalization. This study was a descriptive cross sectional study conducted among the patients dually diagnosed with psychiatric and substance use disorders attending OPD in a tertiary care hospital of Dhaka city, during the period from May 2013 to November 2013. The main objective of the study was to explore the proportion of psychotropic medication adherence among the respondents who were on such medication for at least last 6 months (N=151). Respondents were selected purposefully. An informed consent was taken from the patients or care givers and data were collected using the questionnaire designed by the researcher based on Factors Influencing Neuroleptic Medication Taking Scale (FNIMTS). Diagnoses were done previously according to DSM-IV TR by psychiatrist appointed in inpatient and outpatient department. Questionnaire was filled up by the researcher by interviewing the patients and attending care givers as needed. Over half of the respondents (57.0%) admitted they had missed taking their medications on more than one occasion in the week prior to the interview. Thus this study found the proportion of medication adherence to be 43% among the respondents.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 602-609


2020 ◽  
Vol 27 (07) ◽  
pp. 1488-1492
Author(s):  
Muhammad Ilyas Jat ◽  
Muhammad Tarique Arain ◽  
Saima Qureshi ◽  
Kheenpal Das ◽  
Anum Haider

The use psychoactive substances are on the rise in general population and even seen more among those who are involved in criminal activities. There are many reasons for such irrational use of psychoactive substances. Objectives: To determine the prevalence and reasons of use of different psychoactive substances among prisoners at Malir prison, Karachi. Study Design: Descriptive Cross-Sectional study. Setting: Malir prison, Karachi. Period: 22nd April 2019 to 26th May 2019. Material & Methods: This study was conducted at district Malir prison, Karachi. All the cases who were imprisoned due to any reason and had history of psychoactive substance use were enrolled. Thorough history and examination was carried out. Ethical considerations were taken as per international guidelines. Results: Among all 490 male prisoners who used to take different type of psychoactive substance, majority were of age ranges of 21 to 35 years and 55% were married while 44% were single and 1% were divorced or separated. Out of 490 cases 453 (92%) were using different substances thorough routes other than injections while 37 (8%) were injection users. Majority of prisoners 252 (52%) were using Heroin while 86 (17%) were using Crystals, 74 (15%) Cannabis, 37 (8%) Synthetic substances, 24 (5%) Ice, 6 (1%) Opioid and 11 (2%) were using some other type of substance. The most common reason of substance use was peer pressure followed by fun and frustration. Conclusion: Substance use prevalence is high in prison. Existing services for the management of drug dependence are not meeting the global standard of evidence based comprehensive drug treatment and rehabilitation.


2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Nkporbu A. K ◽  
Ayodeji O.A

HIV infection is an endemic communicable chronic disease, of enormous public health concern worldwide particularly, Sub-Saharan African. Substance use and associated psychiatric co-morbidity among the sufferers may affect medication adherence. The aim of this study, therefore, was to determine the effect of psychiatric comorbidity and substance use on medication adherence among people living with HIV at the University of Port Harcourt Teaching Hospital. A cross-sectional study was conducted among 230 Subjects Living with HIV. Sociodemographic questionnaire was used. A structured questionnaire was used to assess use of psychoactive substances. Psychiatric co-morbidity was assessed using the GHQ-12 in conjunction with the DSM 5. The Medication Adherence Rating Scale (MARS) was used to assess medication adherence. Data was analysed using the SPSS version 20. The prevalence of psychological co-morbidity among PLWHIV was 30.6%. Alcohol use disorders was the highest with 73 (31.7%), followed by cigarette smoking 38 (16.5%) while nicotine snuffing was the least with 1 (0.4%). Of the 43 (18.7%) with poor medication adherence, 31 (15.2%) had psychiatric co-morbidity, 26 (11.3%) had substance use, 25 (10.8%) had both psychiatric and substance use co-morbidity while 19 (8.2%) had none (p=0.004). Psychological co-morbidity and substance use are prevalent among PLWHIV, and may affect medication adherence.


2018 ◽  
Vol 18 (1) ◽  
pp. 97-106
Author(s):  
Viviana Cruz Ramírez ◽  
Carlos Gómez Restrepo ◽  
Carlos J Rincón

Introducción: Se ha propuesto una estrecha asociación entre trastornos del afecto y ansiedad en adolescentes con consumo de sustancias. Objetivo: Determinar la prevalencia del consumo de sustancias psicoactivas y los trastornos mentales más frecuentes asociados éste consumo, en adolescentes colombianos. Metodología: Estudio transversal, con datos de la Encuesta Nacional de Salud Mental 2015. Con adolescentes entre 12 y 17 años, en quienes se les aplicó CIDI-CAPI (versión 21.1.3) asistida por computador y Assist modificado. Resultados: Se describió información de 408 adolescentes entre 12 y 17 años que reportan consumo de sustancias psicoactivas por lo menos una vez en la vida, siendo una muestra representativa a nivel nacional. Se encontró que la sustancia de mayor consumo fue el alcohol con una prevalencia de 16,6% (IC95% 14,2-19,2), Bogotá constituye la región con mayor consumo de sustancias con una prevalencia de 33,8% (IC95% 24,7-44,2). Ser hombre entre los 16 y 17 años representa un factor de riesgo para consumo de sustancias, así mismo, presentar trastornos del afecto aumenta 2,28 veces el riesgo de consumo de sustancias psicoactivas. Conclusiones: La población adolescente con trastornos del afecto o ansiedad se encuentra en mayor riesgo de consumir sustancias psicoactivas. Introduction: An association between affective and anxiety disorders has been proposed in adolescents with substance use. Objective: To determine the prevalence of psychoactive substance use and the most frequent mental disorders associated with this consumption, in Colombian adolescents. Methods: This is a cross-sectional study that uses data from the National Mental Health Survey 2015. With adolescents between 12 and 17 years old, in whom CIDI-CAPI (version 21.1.3) was applied by computer and modified ASSIST. Results: A total of 408 adolescents between 12 and 17 years old who reported psychoactive substance use at least once in their lives were described , this group was  a representative sample of national population. The most frequent consumed substance was alcohol with a prevalence of 16.6% (95% CI, 14.2-19.2), Bogotá is the region with the highest consumption of substances with a prevalence of 33.8% (IC95 % 24.7-44.2). Otherwise, being a man between 16 and 17 years old represents a risk factor for substance use. Likewise, presenting affective disorders increases by 2.28 times the risk of psychoactive substance use. Conclusions: adolescents with affective or anxiety disorders are at higher risk of psychoactive substances use, making difficult the treatment and desmonstrating the vulnerability of this population. 


2018 ◽  
Vol 40 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Godspower O. Owie ◽  
Sunday O. Olotu ◽  
Bawo O. James

Abstract Introduction Assessing adherence in schizophrenia facilitates interventions that optimize outcomes. Adherence rating questionnaires are feasible and non-intrusive; however, no validated measure exists in sub-Saharan Africa. We aimed to assess the psychometric properties of the 10-item Medication Adherence Rating Scale (MARS). Methods This was a cross-sectional study of a cohort of patients with schizophrenia (n=230). A sociodemographic questionnaire, the Mini International Neuropsychiatric Interview (MINI), Positive and Negative Syndrome Scale (PANSS), Scale for the Unawareness of Mental Disorder (SUMD) and the MARS were all administered by an interviewer. Results The MARS demonstrated good reliability (Cronbach’s alpha: 0.76). The scale was reducible to a 3-factor construct (1 – medication adherence behavior, 2 – attitude to taking medications, and 3 – negative side effects and attitude to psychotropics), with significant though weak external validity in relation to psychopathology (p<0.001) and insight (p<0.001). The first factor showed good internal consistency (α=0.80), comprising six items that could serve as a reliable proxy measure of adherence in place of the MARS Conclusion The MARS demonstrated fair psychometric characteristics in assessing adherence in patients with schizophrenia in this cohort. The scale may be useful in the dimensional assessment of medication adherence for schizophrenia in sub-Saharan African settings.


2014 ◽  
Vol 36 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Andressa Jacondino Pires ◽  
Camila Corrêa Casanova ◽  
Luciana de Avila Quevedo ◽  
Karen Jansen ◽  
Ricardo Azevedo da Silva

Objective: To identify the association between panic disorder and licit and illicit substance use in the population provided with primary care in the southern Brazil. Methods: This is a cross-sectional study with patients from three primary care centers. We used the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to evaluate substance use and the Mini International Neuropsychiatric Interview (MINI) to diagnose panic disorder. Results: A total of 1,081 subjects were evaluated. The prevalence of panic disorder was 5.6%. Panic disorder was associated with using marijuana (p = 0.001), tobacco (p = 0.001), cocaine (p < 0.001), and other illicit substances (p < 0.001). Conclusion: A significant association is noticed between panic disorder and licit and illicit substance use, thus, it is interesting to rethink the approach to treatment/intervention in patients with dual diagnosis.


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