Factors associated with non-adherence to antipsychotic medication among young adult with mental disorders at Muhimbili National Hospital Dar es salaaam, Tanzania

Abstract

Background; Adherence to antipsychotic medication remains one of the greatest challenges in treatment of psychiatric disorders and, is a significant barrier to the successful of treatment of mentally ill. Young adults present the most affected group with psychiatric disorders at Muhimbili National Hospital (MNH) and estimates and reasons for non-adherence to antipsychotic medication among these youngsters may provide an opportunity for improved patient outcomes if challenges are identified and improved upon. Method; Descriptive qualitative design was used to obtain information, to the factors associated with non-adherence to antipsychotic medication among young adults with mental disorders at MNH. In-depth interview and focused group discussions (FGD) guided by semi structured questionnaires were conducted in two waves. The main informants were the patient themselves and their relatives and these were recruited from the psychiatric unit after the psycho-education sessions, which conducted every morning before the start of clinic. Notes and record on the patient's responses was made which followed by the content data analysis after transcription of the text, Results; This study found that development of side effects, perceived cause of mental disorder, stigma, lack of social support, poor socio-economic status, and unavailability of medication at clinics are important factors that contribute to no-adherence. Failure to adhere to antipsychotic medication is associated with exacerbation of psychotic symptoms, psychotic relapse, and hospitalization. Conclusion; This study found that non-adherence behavior continues to be a significant issue in the management of psychotic disorders especially among young adults. The promotion of patient's functional coping behavior to medication side effects for patients with insight will be a key action for improvement. Development of specific nursing care plans to monitor adherence would be important as well increased training of psychiatric nurses to work in the primary care health facilities would be a long term solution.