Factors Associated with Non-adherence to Medication among Patients with Schizophrenia consulting from January to June 2021 at Ndera Neuropsychiatric Hospital

Abstract

Introduction: Non-adherence to medications is a common and complex challenge among patients with schizophrenia, leading to poor outcomes and low quality of life. However, there is a lack of studies to determine factors associated with poor adherence to antipsychotic medications at Ndera Neuropsychiatric Hospital, which is the largest hospital treating mental health disorders in Rwanda. 

Methods: This mixed-method study employed a cross-sectional design using a self-administered questionnaire and face-to-face interviews. Descriptive analysis and chi-square test were performed, and SPSS (Version 21) was used to analyze quantitative data. Qualitative data were also analyzed using thematic method. 

Results: Among 343 patients recruited, 26.2% were adherent to antipsychotic medications, 57.2% were partially adherent, and 16.9% were not adherent to medications. Education, residence, employment, and marital status were significantly associated with adherence (p<0.001, p<0.001, p=0.045, and p=0.013, respectively). During interviews, participants reported a lack of understanding of the disease and benefits of the treatment, poor perceptions, fear of treatment side-effects, chronicity of the disease and long-term uptake of medications, financial constraint and lack of social support, religious and cultural beliefs, and poor healthcare provider-patient relationship and communication are factors preventing them from adhering to medications. 

Conclusions: This study revealed a high prevalence of non-adherence to prescribed medications among schizophrenia patients, with multiple complex factors contributing to this issue. Addressing these challenges requires a multifaceted approach encompassing education, social and financial support, and raising awareness at the individual and community levels.