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Abstract

Schizophrenia is a chronic condition associated with poor psycho-social and medical outcomes. Non-adherence to antipsychotic medications accounts for most of the relapses in schizophrenia, resulting in frequent hospital readmissions, self-harm, violence, and poor cognitive, clinical, and functional outcome. This multi-center study examined the role of therapeutic alliance in medication adherence. One hundred and eight (108) schizophrenia patients aged 18-60 years were recruited for the study through a purposive sampling technique. The study was conducted at the Bono Regional Hospital and the Sunyani Municipal Hospital in Ghana. The Medication Adherence Rating Scale (MARS) and the Scale to Assess the Therapeutic Relationship-Patients version (STAR-P) were adapted for the study. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. Most of the respondents were between 18 and 35 years (85.2%) of age. Males constituted 61.1% of the sample. A larger proportion of the respondents were residents of urban communities (66.7%). More than half of the sample did not have any formal education (51.9%) and 51.9% were unemployed. The mean (standard deviation) for the overall medication adherence and the therapeutic alliance was 4.56 (± 1.715) and 42.16 (± 7.710) respectively. There was no association between overall therapeutic alliance and medication adherence, rs = .14, n = 108, p = .146. However, affective bond showed a weak negative correlation with medication adherence, rs = .19, n = 108, p = .044. This finding indicates the need for clinicians to consistently seek patients’ views and concerns at each level of their treatment to achieve optimum outcomes.

Keywords

Medication adherence Patient Schizophrenia Therapeutic alliance Sunyani

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How to Cite
Nketia, R., & Menokpor, J. R. (2022). Improving Medication Adherence among Patients with Schizophrenia in the Sunyani Municipality, Ghana: The Role of Therapeutic Alliance. International Journal of Multidisciplinary Studies and Innovative Research, 10(2), 1538–1548. https://doi.org/10.53075/Ijmsirq/6564325244
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References

  1. American Psychological Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC., United States: American Psychiatric Association.
  2. Arnow, B. A., & Steidtmann, D. (2014). Harnessing the potential of the therapeutic alliance. World Psychiatry, 13, 10–12.
  3. Asare, B. Y., Baa, D., Dwumfour-asare, B., & Adam, A. (2019). Factors associated with adolescent pregnancy in the Sunyani Municipality of Ghana. International Journal of Africa Nursing Sciences, 10, 87–91. https://doi.org/10.1016/j.ijans.2019.02.001
  4. Chang, J. G., Roh, D., & Kim, C. (2019). Association between therapeutic alliance and adherence in outpatient schizophrenia patients. Clinical Psychopharmacology and Neuroscience, 17(2), 273–278. https://doi.org/10.9758/cpn.2019.17.2.273
  5. Charlson, F. J., Ferrari, A. J., Santomauro, D. F., Diminic, S., Stockings, E., Scott, J. G., Mcgrath, J. J., & Whiteford, H. A. (2018). Global Epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016. Schizophrenia Bulletin, 44(6), 1195–1203. https://doi.org/10.1093/schbul/sby058
  6. Deniz, S., Akbolat, M., Cimen, M., & Unal, O. (2021). The mediating role of shared decision-making in the effect of the patient–physician relationship on compliance with treatment. Journal of Patient Experience, 8, 1–5. https://doi.org/10.1177/23743735211018066
  7. Donald, D. U., State, O., & State, O. (2022). Improving Medication Adherence in Convalescent Psychiatric out-patients exposed to psychotomimetic medications in South-West, Nigeria: The role of medication literacy and therapeutic relationships. Journal of Case Reports and Medical History, 2(1), 1–7. https://doi.org/10.54289/JCRMH2200101
  8. Fenton, W. S., Blyler, C. R., & Heinssen, R. K. (1986). Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin, 23(4), 637–651.
  9. García, S., Martínez-Cengotitabengoa, M., López-Zurbano, S., Zorrilla, I., López, P., Vieta, E., & González-Pinto, A. (2016). Adherence to antipsychotic medication in bipolar disorder and schizophrenic patients. A systematic review. Journal of Clinical Psychopharmacology, 36(4), 355–371. https://doi.org/10.1097/JCP.0000000000000523
  10. Grover, S., Mallnaik, S., Chakrabarti, S., & Mehra, A. (2021). Factors associated with dropout from treatment: An exploratory study. Indian J Psychiatry, 63, 41–51. https://doi.org/10.4103/psychiatry.IndianJPsychiatry
  11. Hasiso, T. Y., & Desse, T. A. (2016). Adherence to treatment and factors affecting adherence of epileptic patients at Yirgalem General Hospital, Southern Ethiopia: A prospective cross-sectional study. PLoS ONE, 11(9), 1–12. https://doi.org/10.1371/journal.pone.0163040
  12. Hsieh, W. L., Yeh, S. T., Liu, W. I., Li, I. H., Lee, S. K., & Chien, W. T. (2022). Improving medication adherence in community-dwelling patients with schizophrenia through therapeutic alliance and medication attitude: a serial multiple mediation model. Patient Preference and Adherence, 16, 1017–1026. https://doi.org/10.2147/PPA.S351848
  13. Jääskeläinen, E., Juola, P., Hirvonen, N., Mcgrath, J. J., Saha, S., Isohanni, M., Veijola, J., & Miettunen, J. (2013). A systematic review and meta-analysis of recovery in schizophrenia. Schizophrenia Bulletin, 39(6), 1296–1306. https://doi.org/10.1093/schbul/sbs130
  14. Kareem, M. M. A., & Mahmood, H. N. (2022). Adherence to pharmacological treatment among patients with schizophrenia. Iraqi National Journal of Medicine, 4(1), 31–42. https://doi.org/10.37319/iqnjm.4.1.4
  15. Kiiza, E., Id, M., Nakasujja, N., Nakku, J., Nanyonga, A., Gumikiriza, J. L., Bangirana, P., Akena, D., & Musisi, S. (2020). One year prevalence of psychotic disorders among first treatment contact patients at the National Psychiatric Referral and Teaching Hospital in Uganda. PLoS ONE, 58(1), 1–13. https://doi.org/10.1371/journal.pone.0218843
  16. Leclerc, E., Noto, C., Bressan, R. A., & Brietzke, E. (2015). Determinants of adherence to treatment in first-episode psychosis: a comprehensive review. Revista Brasileira de Psiquiatria, 37, 168–176. https://doi.org/10.1590/1516-4446-2014-1539
  17. Maqbali, M. H. Al, Almashrafi, M. R., Alrisi, K. A., Albreiki, M. H., Asiri, W. M., & Aljaradi, A. S. (2022). Non-adherence to medications among patients with mental disorders attending tertiary care in Oman. International Journal of Community Medicine and Public Health, 9(2), 642–646. https://doi.org/10.18203/2394-6040.ijcmph20220221
  18. Mathes, T., Jaschinski, T., & Pieper, D. (2014). Adherence influencing factors – a systematic review of systematic reviews. Archives of Public Health, 72, 1–9. https://doi.org/10.1186/2049-3258-72-37
  19. McGuire-Snieckus, R., McCabe, R., Catty, J., Hansson, L., & Priebe, S. (2007). A new scale to assess the therapeutic relationship in community mental health care: STAR. Psychological Medicine, 37, 85–95. https://doi.org/10.1017/S0033291706009299
  20. Ministry of Finance - Ghana. (2022). PBB estimates for Sunyani Municipal. Accra: Ministry of Finance – Ghana.
  21. Mohammed, S., Bonsing, I., Yakubu, I., & Wondong, W. P. (2019). Maternal obstetric and socio-demographic determinants of low birth weight: a retrospective cross-sectional study in Ghana. Reproductive Health, 5(2), 1–9. https://doi.org/10.1186/s12978-019-0742-5
  22. Nketia, R., Mahama, S., Azure, S. A., Adobasom-Anane, A. G., Arthur, F. N., & Atta-Nyarko, D. (2022). Association between nutritional knowledge and dietary compliance among type 2 diabetes mellitus patients at the Bono Regional Hospital, Sunyani, Ghana. International Journal of Multidisciplinary Studies and Innovative Research, 10(01), 1397–1418. https://doi.org/10.53075/Ijmsirq/6867556758
  23. Owie, G. O., Hospital, F. P., Olotu, S. O., & James, B. O. (2018). Reliability and validity of the Medication Adherence Rating Scale in a cohort of patients with schizophrenia from Nigeria. Trends Psychiatry Psychother, 00(0), 1–8. https://doi.org/10.1590/2237-6089-2017-0077
  24. Pallant, J. (2016). SPSS Survival Manual (6th Ed.). Berkshire, England: Open University Press.
  25. Peña, S. S., Bravo, M. del M. P., Tomás, M. Á. C., Martínez, P. A., Guillén, C. P., & Jiménez-Ruiz, I. (2021). Factors affecting adherence to antiretroviral treatment in women with HIV: A sequential mixed model research design. Enfermería Global, 18–34. https://doi.org/10.6018/eglobal.437711
  26. Sankoh, O., Sevalie, S., & Weston, M. (2018). Mental health in Africa. The Lancet Global Health, 6(9), e954–e955. https://doi.org/10.1016/S2214-109X(18)30303-6
  27. Tessier, A., Boyer, L., Husky, M., Baylé, F., Llorca, P., & Misdrahi, D. (2017). Medication adherence in schizophrenia: The role of insight, therapeutic alliance and perceived trauma associated with psychiatric care. Psychiatry Research, 257, 315–321. https://doi.org/10.1016/j.psychres.2017.07.063
  28. Thompson, K., Kulkarni, J., & Sergejew, A. A. (2000). Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophrenia Research 42, 42, 241–247.
  29. World Health Organization. (2022a). Schizophrenia. World Health Organization. Accessed on September 12, 2022. Available at https://www.who.int/news-room/fact-sheets/detail/schizophrenia
  30. World Health Organization. (2022b). Ghana WHO Special Initiative for Mental Health Situational Assessment. Geneva: World Health Organization.
  31. Zacharia, T. (2022). An intercultural perspective toward supporting antipsychotic medication adherence in clinical practice. BJPsych Bulletin, 1–6. https://doi.org/10.1192/bjb.2022.19

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