Antipsychotic medication adherence and satisfaction among Palestinian people with schizophrenia.

BACKGROUND: In Arab and Muslim-dominated countries, spirituality and religiosity shape the belief and practices toward chronic illnesses. No previous studies were published to assess adherence to and satisfaction with antipsychotic medications in persons with schizophrenia in the Arab world. OBJECTIVE: To assess medication adherence and treatment satisfaction with antipsychotics in a sample of Palestinian people with schizophrenia. METHODOLOGY: Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Psychiatric symptoms were assessed using the expanded Brief Psychiatric Rating Scale (BPRS-E). Data were entered and statistically analyzed using SPSS 16 for windows. RESULTS: A convenience sample of 131 persons with schizophrenia was studied. Based on MMAS-8, 44 persons (33.6%) had a low rate, 58 (44.3%) had a medium rate and 29 (22.1%) had a high rate of adherence. Age was significantly correlated (P=0.028) with adherence score. However, variables like use of monotherapy or atypical or depot antipsychotics were not significantly associated with higher adherence. The means of satisfaction with regard to effectiveness, side effects, convenience and global satisfaction were 72.6 ± 20.5, 67.9 ± 31.47, 63.2 ± 14.3 and 63.1 ± 18.8 respectively. There was a significant difference in the means of effectiveness (P < 0.01), convenience (P < 0.01), global satisfaction (P < 0.01), but not side effects domains (P=0.1) among persons with different levels of adherence. Furthermore, there was a significant difference in the means of positive symptom score (P < 0.01), manic (P < 0.01) and depression (P < 0.01) but not negative symptom score (P=0.4) among persons with different levels of adherence. CONCLUSIONS: Medication nonadherence was common and was associated with low treatment satisfaction scores and poor psychiatric scores. Medication related factors had insignificant effects on adherence scores.

Self-reported medication adherence and treatment satisfaction in patients with epilepsy.

OBJECTIVE: Reports about medication adherence and satisfaction in patients with epilepsy in Arab countries are lacking. The objective of this study was to assess medication adherence and its relationship with treatment satisfaction, number of antiepileptic drugs (AEDs) taken, and epilepsy control in a sample of Palestinian patients. METHODS: This cross-sectional descriptive study was carried out at Al-Makhfya Governmental Outpatient Center in Nablus, Palestine, during the summer of 2010. A convenience sampling method was used to select patients over the study period. Medication adherence was measured using the eight-item Morisky Medication Adherence Scale (MMAS); treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Epilepsy was arbitrarily defined as "well controlled" if the patient had had no seizures in the last 3 months and was defined as "poorly controlled" if he or she had had at least one seizure in the last 3 months. RESULTS: A convenience sample of 75 patients was studied. On the basis of the MMAS, 11 patients (14.7%) had a low rate, 37 (49.3%) had a medium rate, and 27 (36%) had a high rate of adherence. Adherence was positively and significantly correlated with age (P=0.02) and duration of illness (P=0.01). No significant difference in adherence was found between patients with well-controlled and those with poorly controlled epilepsy. Similarly, there was no significant difference in adherence between patients on monotherapy and those on polytherapy. Mean satisfaction with respect to effectiveness, side effects, convenience, and global satisfaction were 73.6±20.7, 82.4±29.8, 69.5±15.5, and 68.4±18.3, respectively. There were significant differences in mean values in the effectiveness (P<0.01) and convenience (P<0.01) domains, but not the side effect (P=0.1) and global satisfaction (P=0.08) domains among patients with different levels of adherence. Patients on monotherapy had significantly higher satisfaction in the effectiveness domain (P=0.04) than patients on polytherapy. Similarly, patients with well-controlled epilepsy scored significantly higher in the Effectiveness (P=0.01) and Global Satisfaction (P=0.01) domains than those with poorly controlled epilepsy. CONCLUSION: In our convenience sample, we found that adherence to and satisfaction with AEDs were moderate and were not associated with seizure control or number of AEDs.

Differences in medication adherence, satisfaction and clinical symptoms in schizophrenic outpatients taking different antipsychotic regimens.

OBJECTIVE: To investigate differences in medication adherence, treatment satisfaction and clinical symptoms in schizophrenic outpatients taking different antipsychotic treatment regimens. METHODOLOGY: Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8) while treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Psychiatric symptoms were measured using the 24-item expanded Brief Psychiatric Rating Scale (BPRS-E). Data were entered and analyzed using SPSS 16 for windows. RESULTS: A convenience sample of 131 schizophrenic patients was studied. Patients belonged to 7 groups based on their antipsychotic treatment regimens. There was no significant difference in the means of adherence (P=0.6) and BPRS domains: positive (P=0.6), negative (P=0.8), manic (P=0.2) and depression (P=0.9) scores among the studied groups. Satisfaction with side effect domain was significantly different among studied groups (P=0.006, F=3). However, no significant difference was found in other satisfaction domains: effectiveness (P=0.8), convenience (P=0.3), and global satisfaction (P=0.8). CONCLUSIONS: Medications adherence, most treatment satisfaction domains and clinical symptom scores were not significantly different among patients taking different antipsychotic regimens.