Lucca J M, Ramesh M, Parthasarathi G, Ram D
Department of Pharmacy Practice, JSS College of Pharmacy, JSS University, Mysore, Karnataka, India.
J Postgrad Med. 2015 Oct-Dec;61(4):251-6. doi: 10.4103/0022-3859.166514.
In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients.
A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD)-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS).
Of the 400 patients, 172 (43%) were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001), number of drugs (P = 0.002), family income (P = 0.013), and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32%) and disease-related factors (31%).
The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.
尽管在过去几十年中精神疾病的治疗取得了进展，但不依从治疗仍然是一种常见现象，常常伴有潜在的严重临床后果和医疗费用增加。精神疾病患者中存在许多与药物治疗不依从相关的因素。本研究的目的是确定精神科门诊患者药物治疗不依从的发生率及其相关因素。
在一家印度三级护理私立医院的精神科门诊进行了为期1年的横断面研究。纳入年龄在18岁及以上、根据国际疾病分类（ICD）-10诊断为患有精神疾病且至少接受一种精神药物治疗至少1个月的患者。使用药物治疗依从性评定量表（MARS）评估药物治疗依从性。
400名患者中，172名（43%）未遵医嘱服药。教育程度（P = 0.001）、药物数量（P = 0.002）、家庭收入（P = 0.013）与不依从之间存在统计学显著关联。在172名患者中，33.5%因患者相关因素未遵医嘱治疗，其次是药物相关因素（32%）和疾病相关因素（31%）。
精神疾病患者药物治疗不依从的总体发生率为43%。多种因素导致药物治疗不依从。需要制定和实施提高药物治疗依从性的策略，从而使精神疾病患者获得更好的治疗效果。
