Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Ghana.
Department of Public Health, Falk College, Syracuse University, White Hall, 13244, Syracuse, NY, USA.
Int J Clin Pharm. 2021 Oct;43(5):1370-1380. doi: 10.1007/s11096-021-01264-9. Epub 2021 Apr 9.
Background Medication adherence is essential in the management of schizophrenia. Yet poor treatment uptake has negative consequences on patients and their primary caregivers. Objective To examine the association among beliefs about psychotropic medications, side effects 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-effects 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). Significant positive relations between specific-necessity, necessity-concerns differential and medication adherence were recorded while specific-concern, general harm and side-effects correlated negatively with medication adherence from the dyad. The odds of adhering to medications increased by 58 and 64 % for each unit increase in specific-necessity and general overuse scores respectively. However, a unit increase in specific-concern score and high side-effects 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.
精神分裂症的治疗中，药物依从性至关重要。然而，治疗依从性差会对患者及其主要照顾者产生负面影响。目的：从患者-照顾者双重角度探讨精神药物信念、副作用与依从性之间的关联。地点：本研究在加纳阿克拉的一家公立精神病院进行。方法：采用访谈式数据收集方法，对 121 对患者-照顾者进行横断面研究。主要结局指标：药物信念、副作用与药物依从性。结果：患者和照顾者报告的药物依从性水平为 28.1%。根据 Kappa 指数，患者和照顾者的反应之间的一致性程度从轻微到中度不等。患者和照顾者均认为必要性比顾虑更重要（患者：1.67±0.84，照顾者：1.79±0.96）。特定必要性、必要性-顾虑差异与药物依从性之间存在显著正相关，而特定顾虑、一般伤害和副作用与药物依从性呈负相关。特定必要性和一般过度使用得分每增加一个单位，药物依从性的可能性分别增加 58%和 64%。然而，特定顾虑得分增加和副作用严重程度高与药物依从性降低有关。结论：本研究强调了患者-照顾者合作在精神分裂症药物依从性决策中的重要性。因此，在临床实践中，需要认识到照顾者是重要的合作伙伴，患者和照顾者对精神药物的看法对于改善心理健康结局的药物依从性至关重要。
