Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Systematic Reviews
Abstract
Background: Major psychiatric disorders are growing public health concern that attributed 14% of the global
burden of diseases. The management of major psychiatric disorders is challenging mainly due to medication non adherence. However, there is a paucity of summarized evidence on the prevalence of psychotropic medication
non-adherence and associated factors. Therefore, we aimed to summarize existing primary studies’ finding to
determine the pooled prevalence and factors associated with psychotropic medication non-adherence.
Methods: A total of 4504 studies written in English until December 31, 2017, were searched from the main
databases (n = 3125) (PubMed (MEDLINE), Embase, CINAHL, PsycINFO, and Web of Science) and other relevant
sources (mainly from Google Scholar, n = 1379). Study selection, screening, and data extraction were carried out
independently by two authors. Observational studies that had been conducted among adult patients (18 years and
older) with major psychiatric disorders were eligible for the selection process. Critical appraisal of the included
studies was carried out using the Newcastle Ottawa Scale. Systematic synthesis of the studies was carried out to
summarize factors associated with psychotropic medication non-adherence. Meta-analysis was carried using Stata
14. Random effects model was used to compute the pooled prevalence, and sub-group analysis at 95% confidence
interval.
Results: Forty-six studies were included in the systematic review. Of these, 35 studies (schizophrenia (n = 9),
depressive (n = 16), and bipolar (n = 10) disorders) were included in the meta-analysis. Overall, 49% of major
psychiatric disorder patients were non-adherent to their psychotropic medication. Of these, psychotropic
medication non-adherence for schizophrenia, major depressive disorders, and bipolar disorders were 56%, 50%, and
44%, respectively. Individual patient’s behaviors, lack of social support, clinical or treatment and illness-related, and
health system factors influenced psychotropic medication non-adherence.
Conclusion: Psychotropic medication non-adherence was high. It was influenced by various factors operating at
different levels. Therefore, comprehensive intervention strategies should be designed to address factors associated
with psychotropic medication non-adherence.
Description
Research Article
Keywords
Medication non-adherence, Psychiatric disorders, Systematic review, Meta-analysis