Prevalence and factors associated with medication nonadherence in patients with major psychiatric disorders in Southern India

Objectives: Historically, nonadherence to medication has been a major problem faced by health care workers while treating chronic illnesses. Nonadherence to psychotropic medications is known to be associated with poorer treatment outcomes, remarkable risk, and cost to the medical system in managing psychiatric illness. For care providers, partial compliance or discontinuation of medications represents the difficulty of maintaining treatment successes over time. In this study, we intended to assess medication adherence and to understand the reasons for nonadherence in patients with major psychiatric disorders in southern India. Methods: This is a cross-sectional observational study, done from January to June 2023. With the International Classification of Diseases 10th Revision diagnosis, we assessed patients with psychotic disorders, bipolar affective disorders, and major depressive disorder. The Medication Adherence Rating Scale (MARS) was used to assess medication adherence. The patients also completed copies of semi-structured questionnaire on their sociodemographic characteristics, their medications, and reasons for nonadherence. Results: A total of 147 subjects were assessed. We found that 68.0% of subjects were poorly adherent to the treatment based on MARS, and that only 32.0% of them were strictly adherent to the treatment. The reasons for poor adherences to the medication treatment were carelessness or forgetfulness (21.8%), adverse effects of the medications (16.3%), and the perception of the subject of feeling better (15.6%). Conclusion: More than two thirds of the subjects was found to be non-adherent to the medications. Assessing various reasons for medication adherence will help find strategies to improve medication adherence and thus outcome of the treatment.