MEDICATION NON-ADHERENCE AND ASSOCIATED FACTORS AMONG SCHIZOPHRENIA OUTPATIENT ATTENDEES IN PUBLIC HOSPITALS OF MEKELLE,TIGRAY,ETHIOPIA, 2024

Abstract

Background: Given that adherence to antipsychotic medications is the cornerstone in the treatment and prevention of relapses of schizophrenia, non-adherence is a major problem among patients. Non-adherence to antipsychotic medication has a negative impact on the course of illness, resulting in increased risk of relapse, suicide, psychiatric emergencies, and increased costs to healthcare systems. Despite this fact, there is a paucity of information on medication non-adherence among schizophrenia patients in Ethiopia, particularly in Tigray. Objective: This study aimed to assess the prevalence and associated factors of medication nonadherence among schizophrenia outpatients in public hospitals in Mekelle, Tigray, Ethiopia, 2024. Methods: A hospital-based cross-sectional study was conducted from August 7 to September 13, 2024, at selected public hospitals in Mekelle. Study participants were enrolled using systematic random sampling. Data were collected by face-to-face interview, and medication non-adherence was measured using the Morisky Medication Adherence Scale. Data entry and analysis were done using Epi-data 4.7.0 and SPSS version 27, respectively. A binary logistic regression model was fitted to identify factors associated with medication non-adherence. The strength of association was interpreted using the adjusted odds ratio (AOR) and 95% confidence interval(CI) at the p-value < 0.05 level of significance. Results: A total of 418 respondents participated with a response rate of 98.08%. The prevalence of medication non-adherence was 39.5% [95% CI: 34.8, 44.2%]. Negative attitude towards medication [AOR=5.25; 95% CI: 2.97, 9.29], poor insight into their illness [AOR=4.89; 95% CI: 2.65, 9.01], severe medication side effects [AOR=4.29; 95% CI: 1.06, 17.31], current substance use [AOR=3.39; 95% CI: 1.45, 7.89], poor social support [AOR=3.46; 95% CI: 1.68, 7.10], and duration of illness more than ten years [AOR=3.25; 95% CI: 1.19, 8.83] were significant predictors of the odds of medication non-adherence. Conclusions: This study revealed a high prevalence of medication non-adherence among schizophrenia outpatients in the study facilities which is associated with several predictors. Continuously assessing and managing treatment side effects and substance use, and strengthening psychosocial education are of paramount importance to enhance patients’ adherence and improve their quality of life in the context, and perhaps beyond.