(201) Assessment of Barriers for Medication Non-Adherence in Ambulatory Psychiatric Patients at Tertiary Care Hospital

Publication Number: 875

Background: Medication adherence in psychiatric patients depends on the patients’ medication taking behaviours, following a diet, and/or executing lifestyle changes which ultimately impacts the patients economic and social life. While non-adherence remains a global challenge, it is linked with suicide rates, all-cause mortality and hospitalization among psychiatric patients.

Objectives: To assess the ambulatory psychiatry patients' adherence to psychotropic medications.

Methods: A prospective interventional study was conducted in the psychiatry outpatient department of a tertiary care hospital in Mysore over nine months. The medication adherence was assessed at baseline using medication adherence rating scale (MARS). The barriers for medication non-adherence were also identified by interviewing the patients and caretakers. Further, patients were provided with the educational interventions to improve medication adherence and changes in the medication adherence pattern was assessed at 1st and 2nd follow-up. A descriptive analysis was performed for categorical variables, barriers and for the difference between follow ups.

Results: A total of 120 psychiatric patients were enrolled in the study. A majority of the enrolled patients were females (n=65, 54.1%). Depression (n=44, 36.6%) was the most common diagnosis, followed by Bipolar Affective Disorder (BPAD) (n=22, 18.3%), Schizophrenia (n=9, 7.5%), and Alcohol dependency syndrome (n=9,7.5%). Antidepressants were the most common (n=111, 33.1%) class of psychotropic medciations prescribed. More than half (n=70, 58.3%) of the patients were non-adherent to their prescribed medications at baseline. Poor knowledge of disease and disorder was the most common (n=99, 86.0%) patient related barrier reported at baseline. Which was resolved through adequate educational intervention evident by less frequency of such reports in follow-up 1 (n=36, 41.3%) and 2 (n= 22, 36.1%) respectively.

Conclusions: The education intervention provided by the clinical pharmacist resolved the patient related barriers for medication adherence among patients with psychiatric disorders.