Reason for Noncompliance In Psychiatric Patients – A Hospital Based Study

Compliance is defined as: ‘The extent to which the patient’s behaviour matches the prescriber’s recommendations’. Noncompliance on the other hand is the degree to which a patient does not carry out the clinical recommendations of treating physician. As per Kane non-compliance is defined as patient missing >65% of the medication prescribed. Noncompliance is also one of the most common causes of medication "non-response" in majority of the cases. This study was conducted at outpatient service of Psychiatry unit of a tertiary hospital in north India. A sample of 100 noncompliant patients between 18 to 65 years of age were taken.  Basic demographic information was collected using a socio-demographic proforma. MINI (Mini International Neuropsychiatric Interview – a structured psychiatric interview) was applied for psychiatric evaluation and diagnosis. Different reasons for noncompliance were assessed using the semi structured proforma and Medication Adherence Rating Scale (MARS). It was found that the commonest reasons for noncompliance were lack of insight/awareness, seen in 45%, stigma associated with illnesses 40% and side effects in 38% of the subjects. Common disorders associated with noncompliance were depressive disorders 36%, schizophrenia 28% and bipolar disorder in 21% of the patients due to chronic course and lack of awareness. In psychiatry, medication compliance plays an enormous role in the success or failure of psychopharmacological treatments. Medication noncompliance is associated with relapse, rehospitalisation leading to morbid consequences, and decreases functioning of patients. With better and careful approach to these issues, we can decrease the morbidity and ensure a better outcome for the psychiatric patients.