Impact of Side Effects of Antipsychotics on Attitude and Adherence to Treatment among Adult Psychiatric Outpatients at Mathari Hospital in Kenya

Abstract

Background Early intervention with antipsychotic medication in psychotic disorders increases the likelihood of favorable long term outcome. However, the use of antipsychotics is associated with a significant number of side effects. These side effects affect the patients’ quality of life and the attitude towards their use, which may culminate to non-adherence and hence poor clinical outcome. Objective of the Study To determine the impact of antipsychotic side effects on attitude and adherence to treatment among adult psychiatric outpatients at Mathari Hospital in Kenya. Design This was a cross-sectional study. Method A convenience sample of 164 adult outpatients on antipsychotic medication was recruited. antipsychotic side effects and medication adherence were administered. Data analysis was done using STATA version 10. Results The male to female ratio was 5:4. Most of patients reported experiencing at least one side effect due to their medication [94.14%]. More than half of the patients [53.65%] had a positive attitude towards their medications. Severity of Side effects was positively associated with negative attitude towards medication [P < 0.001].Only 39.63% reported complete adherence to their medication. Extrapyramidal symptoms [p < 0.001], sedation [p= 0.001], cardiovascular side effects [p= 0.002] and gastrointestinal side effects [p=0.037] were significantly associated with reduced likelihood of adherence. Patient who had moderate to severe side effects also had a reduced likelihood of adherence [ p < 0.001].Patient counseling on medication side effects significantly improved adherence to medication [ p= 0.028]. Conclusion There was a high prevalence of antipsychotic side effects. Attitude towards antipsychotics was principally determined by the severity of side effects. Most patients did not completely adhere to their medications because of side effects. However patients who had a positive attitude towards medication had a high likelihood of adherence. Recommendation Efforts should be done to improve patient’s attitude towards treatment by managing the side effects adequately and counseling the patient about his or her medication. Most importantly, clinicians should develop treatment strategies where the regimen with minimal side effects is chosen.