Psychosocial and medical factors affecting treatment compliance in patients attending psychiatric hospital: a study from Kashmir
Keywords:Psychiatric medicine, Medical factors, Social factors
Background: Compliance with medication is decisive for treatment of the psychiatric disorders and is necessary for determining the outcome and prognoses of psychiatric patients. While the causes of poor compliance are multifactorial, the psychiatrist should be aware of such factors and may be able to implement interventions to address those factors. The objective of study was to find out the various medical and social reasons affecting treatment Compliance among patients suffering from psychiatric disorders.
Methods: A Cross-Sectional study from 2011 to 2012 was conducted in IMHANS (Institute of Mental Health and Neurosciences) Srinagar (J&K), a questionnaire was designed, and the questionnaire included questions on socio-demographic variables, psychiatric illnesses, and Medical and psycho-social affecting treatment compliance. A systematic selection method for choosing the respondents was opted, questionnaire was administered on 200 (n=200) patients who attended the Outpatient department during the period. Simple random sampling method was applied for selection of respondents, the first time visitors to OPD were exclude along with repetition of respondents.
Results: Out of 200 respondents studied in the study 41.5 % were males and 58.5% were females. Maximum number of patients (31.5%) studied were in the age group below the 30 years. 3.5% of respondents were in the age group above 70 years. Out of total 200 respondents in the study 74 % of the respondents are in compliance with recommended medicine whereas non-compliance was found in the 26% of studied population. Complications (13.46%) ascending out by usage of psychiatric medicine can be attributed as one of the major case of treatment non-compliance in psychiatric patients, among the psychiatric patients. Accessibility of psychiatric medicine and Financial constrain was also one of the reasons behind the medicine non-compliance (7.69%). Patients with no insight to psychiatric disease also include a good percentage of (5.76 %) of medicine non- compliance.Conclusions: Non-compliance is a dominant factor which causes possibly causes readmission in psychiatric wards. Compliance in psychiatric patients in general could be enhanced and improved by adequate intervention via patient counselling and patient medicinal care and education.
Bruer JT. Methodological rigor and citation frequency in patient compliance literature. American Journal of Public Health. 1982;72:911-1123.
Razali, MS, Yahya H. Compliance with treatment in Schizophrenia: A drug intervention program in a developing country. Acta Psychiatrica Scandinavica. 1995;91:331-5.
Nageotte C, Sulliman G, Duan N, Camp PL. Medication compliance among the seriously mentally ill in a public health system. Social Psychiatry and Psychiatric Epidemiology 1997;32:49-56.
Feuertein, M., E.E. Labbe, & A.R. Kuegmierezyk. Health Psychology: A Psychobiological Perspective. New York: Pleneum Press; 1986.
Fakhoury, W. K. Extent of distress caused by adverse experiences associated with anti-psychotic treatment (abstract). European Neuropsychopharmacology. 1999;9(suppl.5):S131-390.
Fakhoury, W. K., Wright, D. & Wallace, M. Prevalence and extent of distress of adverse effects of antipsychotics among callers to a United Kingdom National Mental Health Helpline. International Clinical Psychopharmacology. 2001;16:153–62.
Rittmannsberger, H., Pachinger, T., Keppelmuller, P., et al. Medication adherence among psychotic patients before admission to inpatient treatment. Psychiatric Services. 2004;55:174–9.
Perkins DO. Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry. 2002;63:1121-8.
Adewuya AO, Owoeye OA, Erinfolami AR, Ogun OC, Dada AU, Akindipe TO. Prevalence and correlates of poor medication adherence amongst psychiatric outpatients in southwestern Nigeria. Gen. Hosp. Psychiatr. 2009;31:167-74.
Huda M, Mustaq MA. Pir Faqir and psychotherapist: Their role in psychosocial intervention of trauma. JK practitioner. 2006;13 (suppl 1):s89-93.
Daltroy, L., Katz, J., Morlino, C. et al. Improving doctor patient communication. Psychiatric Medicine. 1991;2:31–5.
Fenton WS, Blyler CR, Herrissen KK. Determinants of medicinal compliance in schizophrenia, empirical and clinical findings. Schizophrenia Bull. 1997;23:637-51.
Shoib S, Dar MM, Bashir H et al. Psychiatric morbidity and the socio-demographic determinants of patients attempting suicide in Kashmir valley: a cross-sectional study. Int J Health Sci Res. 2012;2(7):45-53.
Roy R, Jahan M, Kumari S, et al. Reasons for Drug Non-Compliance of Psychiatric Patients: A Centre Based Study. Journal of the Indian Academy of Applied Psychology. 2005 January-July;31(1-2):24-8.