Medication adherence in schizophrenia: a comparison between outpatients and relapse cases

Adherence to medication is essential for maximising the outcomes of patients with schizophrenia as the consequences of poor adherence are devastating. The study aimed to compare medication adherence between patients with relapse schizophrenia and those attending psychiatric follow-up clinics, and to determine the factors affecting adherence.

This was a cross-sectional study involving 70 patients with schizophrenia who were divided equally into 2 groups. Medication adherence was assessed with the Medication Adherence Rating Scale. Appropriate instruments were used to measure insight, social support, and psychopathology. Various socio-demographic and clinical variables were explored to find associations with medication adherence.

Medication adherence among patients with schizophrenia was poor; 51% of the patients did not adhere to a medication regimen. Adherence was better in outpatients with schizophrenia (61%) than in relapse cases (39%), although the difference was not statistically significant (t = 1.70; p = 0.09). Besides, relapse patients had significant higher number of admission (X(2) = 22.95; p < 0.05) and severe psychopathology (t = -29.96; p < 0.05), while perceived social support was significantly better in outpatients with schizophrenia (t = 2.90; p < 0.05). Frequency of admission (adjusted b = -0.55; 95% confidence interval [CI], -0.99 to -0.10; p < 0.05) and psychopathology (adjusted b = -0.12; 95% CI, -0.24 to -0.01; p < 0.05) were also significantly associated with medication adherence.

Medication adherence among both groups of patients with schizophrenia was poor. If adherence is addressed appropriately, the number of admissions and severity of psychopathology could be improved.