OBJECTIVES : To evaluate the factors associated with medication nonadherence in patients with psychiatric illness in outpatient settings.

METHODS : The study conducted for six months in the outpatient psychiatric department of a tertiary care teaching hospital in south India. Patients aged 18 and over who have been diagnosed with psychiatric disease (Depression, Bipolar affective disorder, Alcohol dependence syndrome and schizophrenia) as per the International Classification of Diseases (ICD)-10 and received at least one psychotropic drug for at least one month were included in the study. Medication adherence was assessed using the medication adherence rating scale (MARS). Descriptive analysis was performed for all variables.

RESULTS

: A total of 414 patients were enrolled among them 54.8% (n=227) were females. The mean age of the study population was 38.76 years (SD±13.43). The most common diagnoses among patients was depression (54.34%) followed by, bipolar disorder (28.01%), schizophrenia (11.35%) and alcohol dependency syndrome (6.28%). Of 414 patients, 58% (n=239) of patients discontinued their prescribed medication. The factors associated with medication nonadherence were categorized as patient-related, medication-related and disease-related. Under patient-related, financial reason (16.3%), Myths & Misconception (15.8%), irregular follow up (14.6%) are most common reasons. Under medication-related, adverse drug reactions (12.5%) and non-availability of medications (10.4%) were common factors. Under disease-related, lack of insight (10.8%), forgetfulness (5.4%), no improvement in treatment (4.6%) were the most common factors for medication nonadherence.

CONCLUSIONS : Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence and achieve a better therapeutic outcome in patients with mental illness.