Predictors of Non-adherence in Patients Taking Psychotropic Medication and Suggestions to Improve

摘要

Background : Non-adherence to treatment, especially medication is an important area of concern in psychiatry as it contributes to relapse and re-hospitalization of the patients. One of the ways to improve drug adherence is to know crucial factors responsible for poor medication adherence so that proper management strategies may be planned to improve patients’ drug adherence. This article reviews the literature of non-adherence, discusses patients’ reasons for failure to concord with medical advice, elect the predictors of and solutions to the problem of non-adherence. Aims: To discuss the aspects of medication adherence and definition about health behavior and it will examine the predictors of non-adherence in those taking psychotropic medication and provide the physicians with various strategies for improving medication adherence among their patients. Methods: We conducted a MEDLINE database literature search and science direct database were undertaken, limited to English language articles published between 1993 and 2014, using the following search terms: adherence, non-adherence, compliance, Improve medication adherence, strategies for physicians and pharmacists to ensure medication adherence, pharmacotherapy. Conclusion: Medication non-adherence was significantly associated with an increased risk of rehospitalization, emergency room visits, homelessness and symptoms exacerbation. Non-adherence was significantly more likely to have a history of medication non-adherence, substance abuse or dependence, and difficulty recognizing her own symptoms. Patients who became medication non-adherence were significantly less likely to have a good therapeutic alliance form during hospitalization and were more likely to have family members who refused to become involved in their treatment. Community psychiatric services can potentially use effective clinical interventions, approved by scientific evidence, for reducing patient non-adherence. Strategies for adherence include raising information and skill levels, altering characteristics of the regimen, and improving the relationship between the provider and the patient. Provider and the patient awareness with regard to medication adherence can be enhanced with the creative application of behavioral contracts. Adherence promoting efforts can also include rewards and improvement strategies.