Psychotropic medicine beliefs, side efects and adherence in schizophrenia: a patient–caregiver dyad perspective

Abstract

Background Medication adherence is essential in the management of schizophrenia. Yet poor treatment uptake has nega tive consequences on patients and their primary caregivers. Objective To examine the association among beliefs about psychotropic medications, side efects and adherence from a patient-caregiver dyad perspective. Setting This study was conducted in a public psychiatric hospital setting in Accra, Ghana. Methods A cross-sectional study was conducted among 121 patient-caregiver dyads using an interviewer-administered data collection approach.Main outcome measure Beliefs about medicines, side-efects and medication adherence. Results The patient and caregiver-reported level of medication adherence was 28.1%. Using the Kappa index, the level of agreement between the responses of patients and their caregivers ranged from slight to moderate. Both patients and caregivers rated necessity higher than concern (patients: 1.67±0.84, caregiver: 1.79±0.96). Signifcant positive relations between specifc-necessity, necessity–concerns diferential and medication adher ence were recorded while specifc–concern, general harm and side-efects correlated negatively with medication adherence from the dyad. The odds of adhering to medications increased by 58 and 64% for each unit increase in specifc-necessity and general overuse scores respectively. However, a unit increase in specifc–concern score and high side-efects scores were associated with lower odds of adherence. Conclusions This study highlights the need for patient-caregiver collaborations in decision-making relating to medication adherence in schizophrenia. Thus, in clinical practice, there is the need to recognize that caregivers are essential partners, and patient-caregiver views about psychotropic medications are critical in enhancing adherence for positive mental health outcomes.