Navigating the Challenges: Predictors of Non-Adherence to Psychotropic Medications Among Patients with Severe Mental Illnesses in Ethiopia

BACKGROUND: Psychotropic medications, consisting of antidepressants, mood stabilizers, antipsychotics, and anxiolytics, are the pillars of managing mental illnesses. Since there is impairment in judgment, attitude, and stability in patients with severe mental conditions, they are vulnerable to non-adherence, which compromises treatment outcome. Nevertheless, a lack of studies investigating medication non-adherence and its predictors in severe mental illnesses patients in Ethiopia has been noticed. The purpose of this study was to evaluate the extent of non-adherence to psychotropic medication and its predictors in patients with severe mental illnesses in Ethiopia. PATIENTS AND METHODS: A cross-sectional study was carried out among severely ill mental patients attending outpatient psychiatry department at Debre Markos Comprehensive Specialized Hospital. Stratified sampling strategy was used to enroll patients with a variety of mental diseases. The determinants of non-adherence were identified using logistic regression analysis. Statistical significance was determined by a p-value of <0.05 and a 95% confidence range. RESULTS: The prevalence of non-adherence to psychotropic medication was 50.9%. Missing regular follow-up [AOR (95% CI): 2.36 (1.24–4.47)], current substance use [AOR (95% CI): 2.48 (1.44–4.27)], negative attitude towards treatment [AOR (95% CI); 3.87 (2.26–6.62)], experience of side effects [AOR (95% CI); 4.84 (2.74–8.54)], medication use for more than 3 years [AOR (95% CI); 7.16 (3.93–13.06)], and no family support [AOR (95% CI); 2.07 (1.19–3.58)] were predictors of psychotropic medication non-adherence. CONCLUSION: This study generalized that most of the patients were non-adherent to their medications. Missing regular follow-up, current substance use, negative attitude towards treatment, experience of side effects, Medication use for more than 3 years and absence of family support were found to influence medication adherence of the patients. In order to correct patients’, caregivers’, and societal misconceptions regarding the significance of treatment adherence, we recommend the need to implement psycho-educational programs.