Improving compliance in Xhosa psychiatric patients

Compliance with psychotropic medication is particularly poor in Xhosa psychiatric patients. A study demonstrated that explicit and repeated verbal and written instructions did not increase compliance with oral medication, but that a single home visit, limited to giving instructions about medication, almost doubled the compliance rate (to 65%). Similar increases also occurred in relation to intramuscular medication and clinic attendance. The most common reason for noncompliance was found to be resistance to, or plain ignoring of, what was actually known (64%). Several possible reasons for this are proposed, the most significant being the patients' cultural and social attitudes and belief system. Recommendations for increasing compliance are given.