Top

BMC Psychiatry

Published in:

Open Access 01-12-2021 | Research

Participation in a free medication program among non-registered permanent residents with severe mental disorders in Bao’an district, Shenzhen, China and its influencing factors

Authors: Chu-Hong Lu, Jian-Hu Zhong, Ying-Dong Lv, Jia-Li Luo, Juan Cheng, Li Qing, Qing Chen, Cheng-feng Liu

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

In 2016, the government of Bao’an District, Shenzhen, China launched a free medication program for all non-registered permanent residents with severe mental disorders (SMD) within its jurisdiction, in efforts to reduce the relapse caused by intermittent medication or non-medication. Participation in the program has not been analyzed since its inauguration. This study aimed to evaluate the participation of non-registered permanent residents with SMD in the program from 2016 to 2020 and to explore its influencing factors.

Methods

This is a retrospective cross-sectional study of 3760 non-registered permanent residents with SMD in Bao’an District, Shenzhen, China (response rate: 78.64%). Data have been obtained from two sources: the Shenzhen Information System for Psychosis in 2020 and the free medication program’s management files from 2016 to 2020. We employ descriptive statistics to analyze the participation rate of the free medication program among non-registered permanent patients. Logistic regression analysis is used to explore the factors affecting the patients’ participation in the program.

Results

The participation rate of the free medication program among non-registered permanent patients has shown an upward trend, rising from 28.83% in 2016 to 58.32% in 2020. High participation rates have been registered among the following patient subgroups: those aged between 30 and 39 (63.11%), those with high school/technical secondary school (62.33%), those from rural areas (61.62%), those living in poverty (67.79%), those suffering schizoaffective disorder (72.26%), those having SMD for less than 5 years (59.89%), and those with family history of mental illness (71.23%).Logistics regression analysis shows that age, patient-guardian relationship, place of residence, financial condition, types of disease, duration of illness and family history are the main factors affecting the patients’ decision to participate in the free medication program.

Conclusion

The steadily increasing participation rate of the free medication program indicates that the program has been gradually accepted and recognized by non-registered permanent residents with SMD. However, nearly half of the patients have yet to join the program. To further raise the participation rate, special attention should be given to patients who are financially secure, aged below 20, without guardians, intellectually disabled or suffering SMD for over 5 years.

Chen HH, Phillips MR, Cheng H, Chen QQ, Chen XD, Fralick D, et al. Mental health law of the People’s republic of China (English translation with annotations). Shanghai Arch Psychiatry. 2012;24(6):305–21. https://doi.org/10.3969/j.issn.1002-0829.2012.06.001.CrossRefPubMedPubMedCentral

Xinhua News Agency. The number of patients with severe mental disorders registered in China reached 5.81 million. Available from: http:// www. xinhuanet. com/2018–01/26/c_1122323778.htm. Accessed 12 Aug 2019.

Gao ZZ, Cao XY, Zhu JP, Zhu GH, Gao WB, Kong HH, et al. The third epidemiological survey of mental disorders in Weifang (Chinese). Chin J Nerv Ment Dis. 2006;32(2):152–3. https://doi.org/10.3969/j.issn.1002-0152.2006.02.015.CrossRef

Ulrike S, Neeltje V, Schulze LN, Thea S, Franziska R, Langosch JM, et al. Predictors of medication adherence among patients with severe psychiatric disorders: findings from the baseline assessment of a randomized controlled trial (tecla). BMC Psychiatry. 2018;18(1):155. https://doi.org/10.1186/s12888-018-1737-4.CrossRef

Xu AP, Bu XF, Dong L ,Ge MH, Liu PP, Liu WJ. Effect evaluation of the free medication for poor people with serious mental illness in Weifang. Journal of Psychiatry (Chinese). 2013(03):178–180. doi:https://doi.org/10.3969/j.issn.1009-7201.2013.03.006.

Grover S, Avasthi A, Shah S, Lakdawala B, Chakraborty K, Nebhinani N, et al. Indian psychiatric society multicentric study on assessment of health-care needs of patients with severe mental illnesses. Indian J Psychiatry. 2015;57(2):181–9. https://doi.org/10.4103/0019-5545.158185.CrossRefPubMedPubMedCentral

Good BJ, Good MJ. Significance of the 686 program for China and for global mental health (Chinese). Shanghai Arch Psychiatry. 2012;24(3):175–7. https://doi.org/10.3969/j.issn.1002-0829.2012.03.008.CrossRefPubMedPubMedCentral

Dou L, Hu LL, Zhang N, Cutler H, Li SP. Factors associated with medication adherence among patients with severe mental disorders in China: a propensity score matching study. Patient Prefer Adherence. 2020;14:1329–39. https://doi.org/10.2147/PPA.S255934.CrossRefPubMedPubMedCentral

Liu YB, Li YX, Dai YL, Zhang XM. Analysis on influencing factors of free medication policy for patients with severe mental disorders in Dahongmen area of Beijing (Chinese). Psychol J. 2019;014(013):229,58.

10.

Chen Y, Li B, Huang QZ, Zhou XL, Wang XY, Run F. Survey on medication participation status and fiscal investment in patients with severe mental disorder from 2015 to 2017 in Beijing (Chinese). Practical journal of cardio-cerebrovascular disease. 2019;27(02):57–61. https://doi.org/10.3969/j.issn.1008-5971.2019.02.013.CrossRef

11.

Gan YW. Survey on free psychotropic drug use in community patients with mental disease (Chinese). China Medicine and Pharmacy. 2012;2(14):111–2 CNKI:SUN:GYKX.0.2012–14-072.

12.

Zhu Y, Zhang WB, Wang WL Jiang Q, Guo YP, Kang MY , et al. Study on status and countermeasure of free medication for unemployed poor patients with mental disorder in Shanghai City (Chinese). China Medical Herald.2013,10(34): 109–111+114. doi: CNKI:SUN:YYCY.0.2013–34-040.

13.

Zhang T, Xu XH, Li MS, Wang H, Yang JF, Zheng WB. Analysis on the current situation of taking medication and the participation rate of taking free medication among patients with schizophrenia in remote communities in Yunnan Province (Chinese). Chin J Prev Cnotr Chron Dis.2017,25(01):49–51.doi: 10.16386/j. cjpccd.issn.1004–6194.2017.01.013.

14.

Lu CH, Zhang QS, Zhong JH, Zeng J, Xie Y, Zhu W , et al. Evaluation of the effect of drug fee reduction policy for severe mental disorders in Baoan district, Shenzhen (Chinese). Chronic Pathematology J. 2018,19(08):999–1001+1004.doi: CNKI:SUN:YYSO.0.2018–08-004.

15.

Xiao G, Lu DQ, Li SX. Curative effects of patients with schizophrenia before and after community free treatment (Chinese). Chinese Journal of Rehabilitation. 2009;24(01):71–2. https://doi.org/10.3870/zgkf.2009.01.039.CrossRef

16.

Ding XB, Huang JF. Curative effects analysis of free medication policy for schizophrenic patients in poverty. Medical Journal of Chinese People’s Health (Chinese).2013,25(21):8–10.doi: https://doi.org/10.3969/j.issn.1672-0369.2013.21.004.

17.

Li JH, Lu SL, Yu ZY, Zhong H, Chen HZ, Wu JG. Efficacy of free distributing antipsychotics to the schizophrenics: one year follow-up study (Chinese). Shanghai Archives of Psychiatry. 2008(04):213–215. doi: https://doi.org/10.3969/j.issn.1002-0829.2008.04.007.

18.

Hu LL, Wang C, Wang YH. Effect of medication assistance policy on medication compliance of patients with severe mental disorders (Chinese). J Psychiatry. 2018;31(05):376–8. https://doi.org/10.3969/j.issn.2095-9346.2018.05.015.CrossRef

19.

Zhou Y, Chen SQ, Wu ZM. Effect of social support on rehabilitation of the patients with schizophrenia. (Chinese). Journal of Nursing Science. 2005(19):4–6. doi: CNKI:SUN:HLXZ.0.2005–19-002.

20.

Shenzhen Municipal Bureau of Statistics. Shenzhen Statistical Yearbook 2020. China Statistics Press;2020. Available online: http://www.sz.gov.cn/ cn/xxgk / zfxxgj/tjsj/tjnj/content/post_8386385.html.

21.

CCID Consulting Company Limited. White paper on the development of China's top 100 regions 2018. Available online: https://www.sohu.com/ a/253975439_ 818773. Accessed 14 Sept 2018.

22.

Gao XP. Countermeasures to the management of floating population in urban community (Chinese). J Liaoning Police College. 2019;21(05):67–71.

23.

Yao HS, Xu XJ, Xue DS. Progress of the research on the floating population in China (Chinese). Urban Probl. 2008;6:69–76. https://doi.org/10.3969/j.issn.1002-2031.2008.06.014.CrossRef

24.

Yuan XM. Empirical analysis on current trait and problems of urban floating population in Shanghai (Chinese). East China Econ Manage. 2008;7:4–8. https://doi.org/10.19629/j.cnki.34-1014/f.2008.07.001.CrossRef

25.

Li RF. On the formation of the dual household registration system in China (Chinese). Xi Nan Ke Ji Univ J. 2007;6:16–9. https://doi.org/10.3969/j.issn.1672-4860.2007.06.004.CrossRef

26.

Jiang MH, Wang GY. The social integration of rural female floating population with cities - investigations and considerations in Henan Province (Chinese) . Chinese Women’s Acad Shandong Col J. 2009;3:22–25. doi: CNKI:SUN: ZHLZ. 0.2009–03-008.

27.

Luo JJ, Jiang GQ, Wang QG. Analysis of medication situation of registered patients with severe mental disorders in Chongqing in 2017 (Chinese). China Pharmaceuticals. 2018;27(23):83–6. https://doi.org/10.3969/j.issn.1006-4931.2018.23.027.CrossRef

28.

Liu CF, Chen Q, Lu CH. Qing Li, Cheng Juan, fang WJ. Implementation effect of medication subsidy policy for patients with severe mental disorders. Modern Preventive Medicine. 2021;48(04):690–3.

29.

Chen Y, Li ZB, Xu QY, Huang QZ, Yan F, Yang Y. The effect of free medication service patterns on serious mental disordered patients and fiscal expenditure. Capital Journal of Public Health. 2016;10(04):186–8. https://doi.org/10.16760/j.cnki.sdggws.2016.04.014.CrossRef

30.

Guo ZJ, Wang YJ, Wang CH, Wang HL, Zhang RL, Yao FJ. A study on influencing factors and current status of drug compliance in patients with serious mental disorder in Henan (Chinese). Chin J Psychiatry. 2020;53(04):321–7. https://doi.org/10.3760/cma.j.cn113661-20190731-00254.CrossRef

31.

Mi WF, Ma WB, Xiong J, Shi ZQ, Li LZ, Huang L, et al. Compliance with antipsychotic treatment and relapse in schizophrenia (Chinese). Chinese Journal of Psychiatry. 2012;45(1):25–8. https://doi.org/10.3760/cma.j.issn.1006-7884.2012.01.011.CrossRef

32.

Wang X, Ma N, Wu XM, Guan LL, Guo JH, Zhang WF, et al. Analysis of medication compliance and causation in patients with schizophrenia in community (Chinese). Chin J Nerv Dis. 2016;42(6):374–8. https://doi.org/10.3969/j.issn.1002-0152.2016.06.012.CrossRef

33.

Wu Y, Fan J, Bao ZH, Guo T, Tang L, Feng W, et al. Investigation on medication compliance of patients with severe mental disorders and its influencing factors in the community of Wuxi (Chinese). Chinese General Practice. 2020;23(04):490–4.

34.

He KY, Zhou YQ, Long HW, Li XH, Ou WH. Drug compliance in schizophrenic patients (Chinese). J Clin Psychol Med. 2000;01:9–11. https://doi.org/10.3969/j.issn.1005-3220.2000.01.003.CrossRef

35.

Meng B, Zhang BK, Zhu WG, Chen MH, Wang YS. Evaluation of drug compliance among schizophrenic patients (Chinese). J Clin Psychiatry. 2009, 19 (02): 102–103. (Chinese). doi: CNKI:SUN: LCJS.0. 2009–02- 017.

Title: Participation in a free medication program among non-registered permanent residents with severe mental disorders in Bao’an district, Shenzhen, China and its influencing factors
Authors: Chu-Hong Lu
Jian-Hu Zhong
Ying-Dong Lv
Jia-Li Luo
Juan Cheng
Li Qing
Qing Chen
Cheng-feng Liu
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03485-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Participation in a free medication program among non-registered permanent residents with severe mental disorders in Bao’an district, Shenzhen, China and its influencing factors

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

The effect of counseling on fathers’ stress and anxiety during pregnancy: a randomized controlled clinical trial

Recommendations for occupational therapy interventions for adults with ADHD: a consensus statement from the UK adult ADHD network

Does the millennial generation of women experience more mental illness than their mothers?

Burnout and job satisfaction of psychiatrists in China: a nationwide survey

Sexual and physical abuse and depressive symptoms in the UK Biobank

A distress-continuum, disorder-threshold model of depression: a mixed-methods, latent class analysis study of slum-dwelling young men in Bangladesh