Assessment of drug attitude, medication adherence and quality of life among psychiatric patients in South Indian population: a cross sectional study

Suganya Ganesan, Nitya Selvaraj, Vinoth Krishna Dass, Nalinidevi Jayabalan, Meher Ali Rajamohammad, Isswariya Anandan


Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.

Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).

Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.

Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.


Medication adherence, Pharmacophilic, Quality of life

Full Text:



Venkatashiva BR, Gupta A, Lohiya A, Kharya P. Mental health issues and challenges in India: a review. Int J Sci Res Pub. 2013;3(2):1-8.

World Health Organization. World mental health surveys find mental disorders are widespread, disabling and often go untreated. 2004. Available at:

Math SB, Srinivasaraju R. Indian Psychiatric epidemiological studies: Learning from the past. Indian J Psychiatry. 2010 Jan;52(Suppl1):S95.

Geyer MA, Olivier B, Joëls M, Kahn RS. From antipsychotic to anti-schizophrenia drugs: role of animal models. Trends Pharmacol Sci. 2012 Oct 1;33(10):515-21.

De las Cuevas C. Towards a clarification of terminology in medicine taking behavior: compliance, adherence and concordance are related although different terms with different uses. Curr Clin Pharmacol. 2011 May 1;6(2):74-7.

De las Cuevas C, Peñate W. Explaining pharmacophobia and pharmacophilia in psychiatric patients: relationship with treatment adherence. Human Psychopharmacol: Clin Experimental. 2015 Sep;30(5):377-83.

De las Cuevas C, Peñate W, Cabrera C. Are acceptance and skepticism determinant factors for adherence to drug treatment in psychiatric patients?. J Clin Psychopharmacol. 2016 Dec 1;36(6):724-5.

Chukwujekwu CD, Adesokun OK. Prevalence of medication non-adherence among psychiatric patients in a tertiary hospital in Nigeria. J Biosci Med. 2017;5:1-10.

Dimatteo MR, Giordani PJ, Lepper HS, Croghan TW. Patient adherence and medical treatment outcomes a meta-analysis. Medical Care. 2002 Sep 1:794-811.

Sabate E. Adherence to long-term therapies: evidence for action. World Health Organization 2003. Available at :

Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry. 2002;63:892-909.

Morken G, Widen JH, Grawe RW. Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia. BMC Psychiatry. 2008 Dec;8(1):32.

Rapaport MH, Clary C, Fayyad R, Endicott J. Quality-of-life impairment in depressive and anxiety disorders. Am J Psychiatry. 2005 Jun 1;162(6):1171-8.

Sibitz I, Katschnig H, Goessler R, Unger A, Amering M. Pharmacophilia and pharmacophobia: determinants of patients’ attitudes towards antipsychotic medication. Pharmacopsychiatry. 2005 May;38(03):107-12.

Christudas MJ, Gupta BS, Undela K, Isaac NM, Ram D, Ramesh M. Assessment of impact of pharmacophilia and pharmacophobia on medication adherence in patients with psychiatric disorders: A cross-sectional study. Indian J Pharmacol. 2016 Nov;48(6):701.

Endicott J, Nee J, Harrison W, Blumenthal R. Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure. Psychopharmacol Bulletin. 1993.

Keith SJ, Kane JM. Partial compliance and patient consequences in schizophrenia: our patients can do better. J Clin Psychiatr. 2003 Nov;64(11):1308-15.

Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin. 1997 Jan 1;23(4):637-51.

De las Cuevas C, Marrero R, Cabrera C. Treatment-related decisional conflict in patients with depressive and anxious disorders. Patient Preference Adherence. 2016;10:1011-9.

Hofer A, Kemmler G, Eder U, Honeder M, Hummer M, Fleischhacker WW. Attitudes toward antipsychotics among outpatient clinic attendees with schizophrenia. J Clin Psychiatry. 2002 Jan;63(1):49-53.

Lauber C, Nordt C, Falcato L, Rössler W. Lay recommendations on how to treat mental disorders. Social Psychiatry Psychiatric Epidemiol. 2001 Nov 1;36(11):553-6.

Husain T, Ahmed HF, Maboos M, Gul S. Pharmacophilia: Prevalence and trends in our community. World J Pharm Sci. 2014;2:346-9.

Ritsner M, Kurs R, Gibel A, Ratner Y, Endicott J. Validity of an abbreviated quality of life enjoyment and satisfaction questionnaire (Q-LES-Q-18) for schizophrenia, schizoaffective, and mood disorder patients. Quality Life Res. 2005 Sep 1;14(7):1693-703.

Mick E, Faraone SV, Spencer T, Zhang HF, Biederman J. Assessing the validity of the quality of life enjoyment and satisfaction questionnaire-short form in adults with ADHD. J Attention Disorders. 2008 Jan;11(4):504-9.

Demyttenaere K, Andersen HF, Reines EH. Impact of escitalopram treatment on Quality of Life Enjoyment and Satisfaction Questionnaire scores in major depressive disorder and generalized anxiety disorder. Int Clin Psychopharmacol. 2008 Sep 1;23(5):276-86.