Introduction: Non – compliance to medication in psychiatric disorders costs enormously to patients and health care system. In order to improve the drug compliance it is important to know the crucial factors responsible for poor drug compliance so that proper management strategies may be planned to improve the compliance.
Aim: To study and compare factors affecting compliance among patients with schizophrenia and bipolar disorder in remission and to study and compare severity of medication induced side effects with compliance.
Materials and Methods: A cross sectional study was done on patients who were attending psychiatry review outpatient department of a tertiary care hospital in an urban city for a duration of six months. Subjects were entered on a semi-structure intake pro-forma, compliance was assessed using Hogan’s drug attitude inventory. Severity of side-effects were assessed using LUNSER’s scale.
Results: The percentage of compliance was found to be 36% among patients with schizophrenia and 82% among bipolar patients. In schizophrenia patients compliance was significantly associated with marital status (66.6%) (p= 0.0086), urban domicile (65%) (p= 0.011), diagnosis, fear of relapse of illness (71.43%) (p= 0.035224), presence of stigma (57.5%) (p= 0.017), insight (81.81%) (p= 0.000699), family history of mental illness (80%) (p= 0.0307), comorbid chronic medical conditions (93.33%) (p= 0.004) and presence of substance abuse (83.33%) (p= 0.00001).
Among bipolar patients compliance was significantly associated with illness related factors like fear of relapse (97%) (p= 0.000), insight (70.73%) (p= 0.0342), duration of illness less than 5 years (72.41%) (p= 0.005) and in above 45 years age group patients. (45%) (p= 0.01977)
Conclusion: The factors affecting compliance in schizophrenia and bipolar disorder were determined. The study emphasizes need for psycho education about nature of illness and duration of treatment and improvement of community services to the patient.
Keywords: Schizophrenia, Bipolar disorder, Pharmacotherapy, Compliance.