Medication Adherence in Clinically Stable Patients with Severe Mental Disorder Attending a Tertiary Care Center of North India: An Observational Study

Abstract

Background: Medication non-adherence is a major challenge in severe mental disorder. Objective: The objectives of the study are to see medication adherence in patients with severe mental disorder (schizophrenia and bipolar affective disorder) and compare reasons of medication non-adherence among schizophrenia and bipolar affective disorder. Method: It is a cross-sectional, observational study conducted in a tertiary care center among stable patients with severe mental disorder. Patients were assessed on Mini International Neuropsychiatric Inventory (MINI 5.0 version) to rule out other co-morbid psychiatric illnesses. Psychopathology of the patients was assessed on Positive and Negative Syndrome scale for Schizophrenia (PANSS) for schizophrenia and Young’s Mania Rating Scale (YMRS) 8Hamilton’s Depression Rating Scale (HAM-D) for Bipolar disorder. Medication Adherence Rating Scale (MARS) was applied to assess about medication adherence. Clinical Global Impression (CGI) was used to look for clinical stability. Result: A total of 52 patients were diagnosed with schizophrenia and 53 with bipolar affective disorder were included in the study. Patients with schizophrenia have significantly (p=0.0193) better medication adherence than those with bipolar affective disorder. Forgetting to take medication was the common reason of medication nonadherence in schizophrenia, whereas in bipolar affective disorder most common reasons of non-adherence were - Don’t like to be controlled by medications 8 Taking medications, only when sick. There were not many differences between patients of schizophrenia and bipolar affective disorder in terms of individual reasons of medication non-adherence. Conclusion: Non-adherence to medication is a common phenomenon in patients with severe mental disorder. Multiple factors attribute to medication non-adherence in severe mental disorder. Clinically stable patients of schizophrenia are more adherent to medication than those with bipolar affective disorder.