Level of adherence to antipsychotics and associated factors among patients visiting Mulago Mental Clinic

Abstract

Psychotic disorders, characterized by a loss of contact with reality, are chronic conditions contributing significantly to the global burden of disease. While antipsychotic medications are central to managing these disorders, non-adherence remains a key barrier to effective treatment, especially in low- and middle-income countries like Uganda. This study aimed to determine the level of adherence to antipsychotic medication and identify the associated socio-demographic and clinical factors among patients attending the Mulago Hospital Mental Clinic. A cross-sectional study was conducted for 14 days at the Mulago Mental Clinic. A total of 143 participants were enrolled through systematic sampling. Data were collected using structured questionnaires, then analyzed using SPSS v16.0, applying chi-square, bivariate, and multivariate logistic regression analyses. Associations were determined using odds ratios (OR) and 95% confidence intervals (CI), with significance set at p<0.05. The adherence rate was found to be 57%. Key factors associated with poor adherence included lack of understanding of the illness (AOR = 108.4, p<0.001), experiencing side effects (AOR = 0.028, p<0.001), frustration with treatment complexity, and substance abuse. Conversely, positive predictors of adherence included formal employment, higher education levels, and belief in the effectiveness of medication. While the overall adherence level aligns with global benchmarks, there is room for improvement. Targeted psycho-education, proactive side effect management, and health system improvements are essential to enhance adherence and treatment outcomes for psychiatric patients in Uganda.