Experiences of Medication Adherence Among People with Schizophrenia: A Qualitative Systematic Review

Authors

  • Nisakorn Pothimas RN, PhD., Instructor, Faculty of Nursing, Naresuan University, Phitsanulok, Thailand.
  • Patraporn Tungpunkom RN, APPMH, PhD., FAAN, Associate Professor, The Thailand Centre for EBHC: a JBI Affiliated Group, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
  • Thidarat Kanungpiarn RN, M.N.S., Instructor, Boromarajonani college of Nursing Surin, Surin, Thailand.
  • Karin Hannes MSc, PhD., Associate Professor, Research Group SoMeTHin’K (Social, Methodological and Theoretical Innovation / Kreative), CESO, Faculty of Social Sciences, Belgium.

Keywords:

Antipsychotic medication, Literature review, Medication adherence, Medication compliance, Meta-synthesis, Patient experience, Qualitative, Schizophrenia

Abstract

                 Schizophrenia is a chronic mental illness that affects thought processes, perception, and behavior, and antipsychotic medications are important to control psychotic symptoms. People with schizophrenia who adhere to neuroleptic medication are less likely to relapse than those who do not. This paper reports on a meta-synthesis of qualitative research exploring medication adherence experiences among people with schizophrenia. Published articles written in English from 1999-2019 were searched (January 1999-December 2019), from electronic databases, including CINAHL, PubMed, Science Direct, Scopus, PsycINFO, ProQuest, Dissertations and Theses, and the Thai National Research Repository. Twelve studies were included in the final review.

            Major components that affect medication adherence in people with schizophrenia positively or negatively were gentle pressure, trust and social support, a positive attitude toward disease and treatment, a sense of understanding of the beneficial and negative impact of medication, and financial constraints. We suggest a gentle medication adherence approach that departs from a joint responsibility between the family network and health providers to push people with schizophrenia towards medication uptake and help them develop coping mechanisms to deal with important side effects. Family members and health care providers should consider the patient's concerns about what is perceived as a normal life and a potential future life, taking into account social stigma and financial barriers.

References

World Health Organization. Schizophrenia. [Internet] 2014 Oct 4 [cited 2015 June 16]. Available from: http://www. who.int/mental_health/management/schizophrenia/en/

McGrath J, Saha S, Chant D, Welham J. Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev. 2008;30:67-76. doi:10.1093/epirev/mxn001.

Morgan VA, Castle DJ, Jablensky AV. Do women express and experience psychosis differently from men? epidemiological evidence from the Australian national study of low prevalence (psychotic) disorders. Aust N Z J Psychiatry. 2008;42(1): 74-82. doi:10.1080/00048670701732699.

Saha S, Chant D, Welham J, McGrath J. A systematic review of the prevalence of schizophrenia. PLoS Med. 2005;2(5): 413-33. doi:10.1371/journal.pmed.0020141.

Solanki RK, Singh P, Midha A, Chugh K. Schizophrenia: impact on quality of life. Indian J Psychiatry. 2008;50(3): 181-6. doi: 10.4103/0019-5545.43632.

Brady N, McCain GC. Living with schizophrenia: a family perspective. Online J Issues Nurs. 2005;10(1):112-48.

The National Health Service. Schizophrenia treatment. [internet] 2014 Nov 11 [cited 2015 June 14]. Available from: http://www.nhs.uk/Conditions/Schizophrenia/ Pages/Treatment.aspx

Ascher-Svanum H, Zhu B, Faries DE, Salkever D, Slade EP, Peng X, et al. The cost of relapse and the predictors of relapse in the treatment of schizophrenia. BMC Psychiatry. 2010;10(2):1-7. doi:10.1186/1471-244X-10-2.

Hong J, Windmeijer F, Novick D, Haro JM, Brown J. The cost of relapse in patients with schizophrenia in the European SOHO (schizophrenia outpatient health outcomes) study. Prog Neuropsychopharmacolo Biol Psychiatry. 2009; 33(5):835-41. doi:10.1016/j.pnpbp.2009.03.034.

Almond S, Knapp M, Francois C, Toumi M, Brugha T. Relapse in schizophrenia: costs, clinical outcomes and quality of life. Br J Psychiatry. 2004;184(4):346-51. doi:10.1192/bjp.184.4.346.

World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.

Osterberg L, Blaschke T. Drug therapy: adherence to medication. N Engl J Med. 2005; 353:487-97. doi: 10.1056/NEJMra050100.

Quach PL, Mors O, Christensen TØ, Krarup G, Jørgensen P, Bertelsen M, et al. Predictors of poor adherence to medication among patients with first-episode schizophrenia spectrum disorder. Early Interv Psychiatry. 2009;3(1):66- 74. doi:10.1111/j.1751-7893.2008.00108.x.

Adelufosi AO, Adebowale TO, Abayode O, Mosanya JT. Medication adherence and quality of life among Nigeria outpatients with schizophrenia. Gen Hosp Psychiatry. 2012; 34(1):72-9.doi:10.1016/j.genhosppsych.2011.09.001.

Dassa D, Boyer L, Benoit M, Bourcet S, Raymond P, Bottai T. Factors associated with medication non-adherence in patients suffering from schizophrenia: a cross-sectional study in a universal coverage health-care system. Aust N Z J Psychiatry. 2010;44(10):921-8. doi:10.3109/0004 8674.2010.493503.

Amr M, El-Mogy A, El-Masry R. Adherence in Egyptian patients with schizophrenia: the role of insight, medication beliefs and spirituality. Arab J Psychiatr. 2013;24(1):60- 8. doi:10.12816/0000100.

Ngui AN, Vasiliadis HM, Tempier R. Factors associated with adherence over time to antipsychotic drug treatment. Clin Epidemiol Glob Health. 2015;3(1):3-9. doi: 10.1016/j.cegh.2013.11.001.

Kao YC, Liu YP. Compliance and schizophrenia: the predictive potential of insight into illness, symptoms, and side effects. Compr Psychiatry. 2010;51(6):557-65. doi:10.1016/j.comppsych.2010.03.007.

Meguid M, Essawy HI, Sabry WM, Khalifa DA, Bastawy MA, Ali RR. Understanding medications non adherence in a sample of Egyptian patients with schizophrenia in relation to illness severity and insight. J Psychiatry. 2015;18(5):1-7.

Perkins DO. Predictors of non-compliance in patients with schizophrenia. J Clin Psychiatry. 2002;63(12):1121- 212. doi:10.4088/JCP.v63n1206.

Yamada K, Watanabe K, Nemoto N, Fujita H, Chikaraishi C, Yamauchi K, et al. Prediction of medication noncompliance in outpatients with schizophrenia: 2-year follow-up study. Psychiatry Res. 2006;141(1):61-9. doi:10.1016/j.psychres.2004.07.014.

Tranulis C, Goff D, Henderson DC, Freudenreich OF. Becoming adherent to antipsychotics: a qualitative study of treatment-experienced schizophrenia patients. Psychiatr Serv. 2011;62(8):888-92. doi:10.1176/appi.ps.62.8.888.

Brain C, Allerby K, Sameby B, Quinlan P, Joas E, Karilampi U, et al. Drug attitude and other predict of medication adherence in schizophrenia: 12 months of electronic monitoring (MEMS1) in the Swedish COAST-study. Eur Neuropharmacol. 2013;23(12):1754-62. doi: 10.1016/j.euroneuro.2013.09.001.

Liu-Seifert H, Osuntokun OO, Feldman PD. Factors associated with adherence to treatment with olanzapine and other atypical antipsychotic medications in patients with schizophrenia. Compr Psychiatry. 2012;53(1):107-15. doi:10.1016/j.comppsych. 2010.12.003.

Nose M, Brabui C, Tansella M. How often do patients with psychosis fail to adhere to treatment programmes? a systematic review. Psychol Med. 2003;33(7):1149-60. doi:10.1017/S0033291703008328.

Kamali M, Kelly BD, Clarke M, Browne S, Gervin M, Kinsella A, et al. A prospective evaluation of adherence to medication in first episode schizophrenia. Eur Psychiatry. 2006;21(1):29-33. doi:10.1016/j.eurpsy.2005.05.015.

Tsang HWH, Fung KMT, Corrigan PW. Psycho-social and socio-demographic correlates of medication compliance among people with schizophrenia. J Behav Ther Exp Psy. 2009;40(1):3-14. doi:10.1016/j.jbtep.2008.02.003.

Gaebel W, Riesbeck M, von Wilmsdorff M, Burns T, Derks EM, Kahn RS, et al. Drug attitude as predictor for effectiveness in first-episode schizophrenia: results of an open randomized trial (EUFEST). Eur Neuropharmacol. 2010;20(5):310-6. doi:10.1016/j.euroneuro.2010. 02.001.

Thompson J, Stansfeld JL, Cooper RE, Morant N, Crellin NE, Moncrieff J. Experiences of taking neuroleptic medication and impacts on symptoms, sense of self and agency: a systematic review and thematic synthesis of qualitative data. Soc Psychiatry Psychiatr Epidemiol. 2020;55(2): 151-64. doi: 10.1007/s00127-019-01819-2.

Pothimas N, Tungpunkom P, Kanungpiarn T. Experiences of medication adherence among people with schizophrenia: a systematic review protocol of qualitative evidence. JBI Database Systematic Rev Implement Rep. 2016;14(3): 51-7. doi:10.11124/JBISRIR-2016-2538.

The Joanna Briggs Institute. JBI QARI Critical Appraisal Checklist for Interpretive & Critical Research. [Internet] 2014 [cited 2017 Dec 6]. Available from http:// joannabriggs.org/assets/docs/ jbc/operations/critical AppraisalForms/JBC_Form_CritAp_IntCrit.pdf

The Joanna Briggs Institute. JBI-QARI Data Extraction Form for Interpretive & Critical Research. [Internet] 2014 [cited 2017 Dec 6]. Available from: https://joannabriggs. org/assets/docs/ jbc/operations/ dataExtractionForms/ JBC_Form_DataE_IntCrit.pdf

Munn Z, Porrit K, Lockwood C, Aromataris E, Pearson A. Establishing confidence in the output of qualitative research synthesis: the ConQual approach. BMC Med Res Methodol. 2014;14(108):1-7. doi:10.1186/1471- 2288-14-108.

Hannes K, Lockwood C. Pragmatism as the philosophical foundation for the Joanna Briggs meta‐aggregative approach to qualitative evidence synthesis. J Adv Nurs. 2011;67(7):1632-42. doi:10.1111/j.1365-2648. 2011.05636.x.

Chang Y-T, Tao S-G, Lu C-L. Qualitative inquiry into motivators for maintaining medication adherence among Taiwanese with schizophrenia. Int J Ment Health Nurs. 2013;22(3):272-8. doi:10.1111/j.1447-0349.2012. 00864.x.

Dumas, RE. The lived experience of taking neuroleptic medication by persons with schizophrenia [dissertation]. Arizona: The University of Arizona; 1999.

Leutwyler HC, Fox PJ, Wallhagen M. Medication adherence among older adults with schizophrenia. J Gerontol Nurs. 2013;39(2):26-34. doi:10.3928/00989134-2 0130109-02.

Meshach OE, King KM, Fulton JA. Poor adherence to antipsychotic medications among schizophrenia patients in Nigeria. Int J Cult Ment Health. 2014;7(3):246-58. doi:10.1080/17542863.2013.783091.

Semar DC. Making my own acquaintance: a phenomenological study of taking antipsychotic medication for schizophrenia [dissertation]. Connecticut: University of Connecticut; 2000.

Tranulis C, Goff D, Henderson DC, Freudenreich O. Becoming adherence to antipsychotics: a qualitative study of treatment experienced schizophrenia patients. Psychiatr Serv. 2011; 62(8):888-92. doi:10.1176/ps.62.8.pss6208_0888.

Dash-martyr JM. Perceptions of the stressors influencing medication compliance of individuals recovering from a mental illness while living in supportive housing [Thesis]. Buffalo, NY: D’Youville College; 2003.

Stewart DC, Anthony GB, Chesson R. ‘It’s not my job. I’m the patient not the doctor’: patient perspectives on medicines management in the treatment of schizophrenia patient. Educ Couns. 2010;78(2):212-7. doi:10.1016/ j.pec.2009.06.016.

Phillips L, McCann E. The subjective experiences of people who regularly receive depot neuroleptic medication in the community. J Psychiatr Ment Health Nurs. 2007;14(6): 578-86. doi:10.1111/j.1365-2850.2007.01145.x.

Kurtis, SD. Medication adherence, social support, and recovery: perspectives of individuals with schizophrenia spectrum disorders and their families [dissertation]. Maryland: Towson University; 2012.

Fewster, CA. A comparative investigation into the factors affecting adherence to treatment in a forensic schizophrenic population [dissertation]. Manchester: The University of Manchester; 2008.

Zarea K, Fereidooni-Moghadam M, Hakim A. Adherence to medication regimen in patients with severe and chronic psychiatric disorders: a qualitative study. Ment Health Nurs. 2016;37(11):868-74. doi:10.1080/0161284 0.2016.1239147.

Salzmann-Erikson M, SjÖdin M. A narrative metasynthesis of how people with schizophrenia experience facilitators and barriers in using antipsychotic medication: implication for healthcare professionals. Int J Nurs Stud. 2018;85:7-18. doi:10.1016/j.ijnurstu.2018.05.003.

Brain C, Sameby, Allerby K, Quinlan P, Joas E, Lindström E, et al. Stigma, discrimination and medication adherence in schizophrenia: results from the Swedish COAST study. Psychiatry Res. 2014;220(3):811-7. doi:10.1016/j. psychres.2014.10.016.

Maan CG, Munnawar Hussain MS, Heramani N, Lenin RK. Factors affecting non-compliance among psychiatric patients in the Regional Institute of Medical Sciences, Imphal. IOSR-PHR. 2015;5(1):1-7.

Downloads

Published

2021-03-27

How to Cite

1.
Pothimas N, Tungpunkom P, Kanungpiarn T, Hannes K. Experiences of Medication Adherence Among People with Schizophrenia: A Qualitative Systematic Review. PRIJNR [Internet]. 2021 Mar. 27 [cited 2024 Jul. 1];25(2):229-41. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/241815

Issue

Section

Original paper