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

Abstract

Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.