Participation in a free medication program among non-registered permanent residents with severe mental disorders in Bao’an district, Shenzhen, China and its influencing factors

BACKGROUND: In 2016, the government of Bao’an District, Shenzhen, China launched a free medication program for all non-registered permanent residents with severe mental disorders (SMD) within its jurisdiction, in efforts to reduce the relapse caused by intermittent medication or non-medication. Participation in the program has not been analyzed since its inauguration. This study aimed to evaluate the participation of non-registered permanent residents with SMD in the program from 2016 to 2020 and to explore its influencing factors. METHODS: This is a retrospective cross-sectional study of 3760 non-registered permanent residents with SMD in Bao’an District, Shenzhen, China (response rate: 78.64%). Data have been obtained from two sources: the Shenzhen Information System for Psychosis in 2020 and the free medication program’s management files from 2016 to 2020. We employ descriptive statistics to analyze the participation rate of the free medication program among non-registered permanent patients. Logistic regression analysis is used to explore the factors affecting the patients’ participation in the program. RESULTS: The participation rate of the free medication program among non-registered permanent patients has shown an upward trend, rising from 28.83% in 2016 to 58.32% in 2020. High participation rates have been registered among the following patient subgroups: those aged between 30 and 39 (63.11%), those with high school/technical secondary school (62.33%), those from rural areas (61.62%), those living in poverty (67.79%), those suffering schizoaffective disorder (72.26%), those having SMD for less than 5 years (59.89%), and those with family history of mental illness (71.23%).Logistics regression analysis shows that age, patient-guardian relationship, place of residence, financial condition, types of disease, duration of illness and family history are the main factors affecting the patients’ decision to participate in the free medication program. CONCLUSION: The steadily increasing participation rate of the free medication program indicates that the program has been gradually accepted and recognized by non-registered permanent residents with SMD. However, nearly half of the patients have yet to join the program. To further raise the participation rate, special attention should be given to patients who are financially secure, aged below 20, without guardians, intellectually disabled or suffering SMD for over 5 years.