Zwide Gopolang E, Dewet Zukiswa Tsolekile, Sokudela Funeka B
Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
S Afr J Psychiatr. 2025 Feb 12;31:2345. doi: 10.4102/sajpsychiatry.v31i0.2345. eCollection 2025.
Medication non-adherence is a significant public health concern and is prevalent among mental healthcare users. Approximately 65% of patients with severe mental illness do not adhere to their prescribed medication. Medication nonadherence may worsen mental illness and result in poorer clinical outcomes, including frequent relapses and rehospitalisation rates, as well as long time to remission, which may contribute to increased cost of care.
We explored perspectives regarding reasons for medication non-adherence among readmitted psychiatric patients.
Weskoppies Psychiatric Hospital, Pretoria, South Africa.
We adopted the social constructivism paradigm for this exploratory qualitative study. Purposive sampling was used to select 15 re-admitted patients, who were nonadherent to their medication. Data were collected through individual semi-structured interviews. The interviews were audio recorded and transcribed. The data were thematically analysed, using the principles of grounded theory.
Substance abuse, a lack of family support and poor health literacy were the most common reasons for non-adherence to medication. Other reasons included medication side effects, healthcare system drawbacks and a lack of finances to access healthcare. Some patients did not adhere to their medication because they believed that their mental illnesses were spiritual in origin.
Multiple factors contributed to patients not adhering to their medication, ultimately resulting in their relapse and readmission. Clinicians should be cognisant of these factors when trying to prevent relapse and readmission.
Clinicians also ought to identify patients who are at risk of not adhering to medication. Targeted interventions should be established for tackling medication non-adherence.
药物治疗依从性差是一个重大的公共卫生问题，在精神卫生保健使用者中普遍存在。约65%的重症精神疾病患者不遵医嘱服药。药物治疗依从性差可能会使精神疾病恶化，并导致较差的临床结果，包括频繁复发和再住院率，以及缓解时间长，这可能会导致护理成本增加。
我们探讨了再次入院的精神科患者药物治疗依从性差的原因。
南非比勒陀利亚的韦斯科皮斯精神病医院。
我们采用社会建构主义范式进行这项探索性定性研究。采用目的抽样法选取15名再次入院且不遵医嘱服药的患者。通过个人半结构式访谈收集数据。访谈进行录音并转录。采用扎根理论原则对数据进行主题分析。
药物滥用、缺乏家庭支持和健康素养低是不遵医嘱服药最常见的原因。其他原因包括药物副作用、医疗系统缺陷以及缺乏获得医疗保健的资金。一些患者不遵医嘱服药是因为他们认为自己的精神疾病源于精神层面。
多种因素导致患者不遵医嘱服药，最终导致复发和再次入院。临床医生在试图预防复发和再次入院时应认识到这些因素。
临床医生还应识别有不遵医嘱服药风险的患者。应制定有针对性的干预措施来解决药物治疗依从性差的问题。
