Medication Non-adherence and Use of Traditional Treatment Among Adult Psychiatric Patients in Jimma Town Treated at Jimma University Teaching Hospital Psychiatric Clinic. Community Based Cross-sectional Study, 2016

Birhanie Mekuriaw*, Mubarek Abera, Workinesh Tessema, Liyew Agenagnew, Badiru Dawud, Eba Abdisa, Markos Tesfaye, Daniel Tolosa, Hailemariam Hailsilassie, Matiwos Soboka, Almaz Mamaru, Eyerusalem Yeshgeta and Habtamu Kerebih

Background:  Medication non-adherence is common problem across all branches of medicine including psychiatry especially in severe mental illness. Many people with mental illness are known to use both modern and traditional treatment for their illness. However, the level of medication non-adherence among this group of patients is not yet explored. This study was conducted to assess the magnitude of non-adherence and traditional treatment as well as associated factors with non-adherence.

Methods: Community based cross sectional study was conducted from April June, 2016 in Jimma town. Data was collected using interviewer administered questionnaire and from patients’ medical record. The four-item Morisky medication adherence scale was used to assess degree of medication non adherence. Pre-test was done on patients who had follow-up at Jimma University teaching Hospital psychiatric clinic and outside the study area. Data was analyzed using SPSS version 20 for windows and descriptive statistics and binary logistic regression statistical methods were applied. P-Value of less than 0.05 was considered statistically significant association in the final model.

Results: Out of 300 patients, 61.7% males and 38.3% were females. The prevalence rate of medication nonadherence was 39.3% and 198 (66%) of the participants were traditional treatment users. Using religious types of traditional treatment [AOR=3.763, 95% C.I (1.459, 9.707)], longer duration of treatment (>10 years) [AOR=0.375, 95% C.I (0.155, 0.908)], no history of treatment default [AOR=0.375, 95% C.I (0.155, 0.908)] and no relapse history [AOR=0.365, 95% C.I (0.190, 0.702)] were independently associated variables with medication non-adherence.

Conclusion: This study showed that high magnitude of non-adherence and majority of the participants were users of traditional treatments which significantly affects medication adherence. Therefore, mental health professionals should focus on methods how to work cooperatively with traditional treatment giver to decrease non adherence and improve counseling service for patients about being non adherent and its effect on clinical outcome.