The poor medication adherence in both groups of patients with schizophrenia in this study is contributed by several local factors, which were not explored in this study.
(26) A local study by Ng et al (27) reported that 32.2% of patients who were readmitted to the psychiatric ward of a teaching hospital within 6 months after discharge returned as a result of poor adherence to medication.
If patients perceived that they were getting adequate social support, the rate of medication adherence was relatively elevated as seen in the outpatient group.
This, in turn, may lead to improved medication adherence. This hypothesis is supported by other studies (32, 33) which showed that lack of insight was correlated with poor medication adherence, and a study by Tsang et al (34) in which insight was the strongest predictor of medication adherence.
There was also a significant relationship between psychopathology and medication adherence. Patients who had severe psychotic symptoms showed poor medication adherence.
Logistic regression analysis demonstrated that the medicine-related adherence was found to be independently related (Table 2) to the time of day of taking the medicine (morning is better; OR=3.834; 95% CI-1.768-8.328; p<0.001); presence of exemplification from expenses of medicine (presence is better; OR=3.504; 95% CI-1.640-7.487, p=0.009;); presence of exercise-related adherence (exercising is better; OR=3.692; 95% CI -1.262-10.713; p=0.023) and presence of any other chronic disease (presence is better; or:2.767; 95% CI-1.219-6.257; p=0.035).
The study has revealed that the adherence rates are low in patients with hypertension.
The adherence to medicine was better in patients have chronic disease, who takes the medicine earlier in the day, who have certificate of exemption and who exercises regularly.
The diet-related adherence was found to be better in patients whose income level was higher, who had been informed about the medicine and who were exercising.
In the PatenT study, adherence to recommendation of increasing exercise was found to be 35.1% in women and 54.7% in men.
Patient treatment adherence: concepts, interventions, and measurement.
Adherence to long-term therapies: evidence for action.
Compliance, adherence and therapeutic alliance: steps in the development of self-care.
Qualitative assessment of medication adherence at an urban leprosy outpatient clinic in Hyderabad, India.
The determinants of adherence are multi-factorial and adherence support interventions may need to address multiple barriers.