Assesment of Beliefs about Medicines and Adherence among Patients withSchizophrenia at the Primary Care Unit in Ramallah, Palestine

Aroub Salman Mohammad Salman
عروب سلمان محمد سلمان
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Al-Quds University
Objectives and background: Schizophrenia is a serious mental illness that needs more attention to be paid for. It affects how patients think, feel and behave. The exact causes underlying the problem is still unknown, but a number of risk factors can be identified including genes and environment. The aims of this study were to assess medication adherence to antipsychotic medications and to measure patients’ beliefs about their treatment necessities and concerns, which contribute to their antipsychotics adherence and treatment efficacy.Methodology: One hundred and thirty patients were recruited from the governmental psychiatry clinic in Ramallah in a cross sectional study. The self-reported Morisky-Green-Levine (MGL) scale was used to measure patients’ adherence. Beliefs about medicines questionnaire (BMQ) was used to measure beliefs about medicines.Results: The result in this study indicated that 53.8 % of the sample participants were classified as low-adherent while 46.2% of patients classified as high adherent. The majority of the patients (66.3%) had strong beliefs and necessity in their medications to maintain their good health, more than half of patients (55.4%) were concerned about becoming dependent upon antipsychotics and long-term side effects. The mean score of specific necessity scale of 16.9 (CI 95%, 15.9 - 17.9) and mean score of specific concerns scale of 16.5 (CI 95%, 15.4 - 17.6; P<0.001) were significantly correlated to medication adherence, and the mean of necessity–concern differential was 2.1 (CI 95%, 2.5 – 1.7; p <0.11) . (Extended) Brief .Psychiatric Rating Scale BPRS domains mean scores were: manic 21.4 ± 8.8, depression and anxiety 20.3 ± 6.2, negative symptoms 13.8 ± 4.6 and positive symptoms 17.7 ± 6.3. BPRS mean score was 77.1± 24.9. The multivariate regression model demonstrated that four variables remain significant and associated with non-adherence; no formal education (OR= 2.11; CI: 0.8 – 3.8) (p=0.04), age (OR= 2.88; CI: 1.2 – 4.4) (p = 0.01), having comorbidity (OR= 3.2; CI: 1.9 – 4.3) (p=0.01) and having concerns about side effects (OR= 2.5; CI: 1.2 – 3.9) (p = 0.03); as they are positively correlated to non-adherence.Conclusion: More than half of participants in this study had low adherence to their antipsychotic agents. Most of patients had strong beliefs in the necessity to use their medications. However, high percentage of the patients had concerns about long-term and potential side effects of antipsychotic medications. Therefore, our role as pharmacist is raising patients’ awareness and beliefs about medications for better treatment outcomes; by educating them about anti-psychotics, their adverse events and conducting several interventions regarding patient compliance.