Who Adheres to Antipsychotic Treatment? Demographic and Basic Clinical Characteristics Associated with Medication Adherence among Adults with Schizophrenia in Zimbabwe: A Cross-Sectional Study
Abstract
Antipsychotic medication is a mainstay in the management of schizophrenia but adherence over time is difficult to maintain. The study investigated if commonly accessible demographic and simple clinical factors independently differentiate medication adherence in persons with schizophrenia in Zimbabwe. A quantitative analytical cross-sectional study was carried out among 96 persons who were attending outpatient psychiatric care at the Annex Psychiatric Unit of Parirenyatwa Group of Hospitals, Harare. Participants were sequentially recruited and rated using the 10 item Medication Adherence Rating Scale (MARS). Scores of ≥6 were considered adherent while scores of <6 were considered non-adherent. The pre-specified factors were age, sex, education, employment, marital status, length of illness and past psychiatric hospitalization. Data were analyzed using descriptive statistics, Pearson’s chi-square tests, independent samples t tests and multivariable binary logistic regression in IBM SPSS Statistics Version 29. Mean age was 41.81 years (SD 11.67); 52.1% were males. Thirty-seven (38.5%) participants were classified as adherent and 59 (61.5%) as nonadherent. No significant relationships were observed with sex, education, employment, marital status, age, length of illness or previous psychiatric hospitalization. The multivariable model was not statistically significant, LR χ² (12) = 5.23, p = .950, McFadden pseudo-R 2 = .041. Non-adherence was prevalent yet routine demographic and basic clinical factors had little discriminating value. Findings recommend individualized repeated assessment of medication-taking behavior and exploration of potentially modifying treatment-related, psychological, social and health system aspects. Keywords: schizophrenia; antipsychotic medication; medication adherence; non-adherence; Medication Adherence Rating Scale; Zimbabwe; treatment engagement; psychiatric care