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Published in: Community Mental Health Journal 1/2009

01-02-2009 | Original Paper

Prospective Study of Psychiatric Follow-up Default and Medication Compliance after Discharge at a Psychiatric Hospital in Nigeria

Authors: A. B. Adeponle, A. S. Baduku, M. L. Adelekan, G. T. Suleiman, S. O. Adeyemi

Published in: Community Mental Health Journal | Issue 1/2009

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Abstract

We report a prospective follow-up of 81 patients recently discharged from the hospital. Their hospital attendance pattern, medication compliance, mental state and social functioning were measured. Defaulters were followed up in the community. At 3 months, 49.4% had defaulted, while 51.5% were medication noncompliant. Clinical outcome was best for the Non-Defaulter-Medication Compliant (ND-MC) group, worst for the Defaulter-Medication Non-Compliant (D-MNC) group. Reasons for default include feeling well, financial difficulty, medication side effects and stigma. Medication non-compliant patients were more likely to reside more than 20 km away from hospital. There is an urgent need to provide community psychiatric services to improve patients’ access to services and medication compliance.
Literature
go back to reference Adelekan, M. L., & Ogunlesi, A. O. (1990). Defaulting at a Nigerian National Neuro-psychiatric Hospital. Psychiatric Bulletin, 14(7), 403–405.CrossRef Adelekan, M. L., & Ogunlesi, A. O. (1990). Defaulting at a Nigerian National Neuro-psychiatric Hospital. Psychiatric Bulletin, 14(7), 403–405.CrossRef
go back to reference Adeponle, A., Obembe, O., Gambari, S., & Adeyemi, S. (2007). Missed first appointments: Prevalence and associated factors in first-time attendees at an outpatient psychiatric clinic in Nigeria. Mental Health, Religion and Culture, 10(6), 609–620. Adeponle, A., Obembe, O., Gambari, S., & Adeyemi, S. (2007). Missed first appointments: Prevalence and associated factors in first-time attendees at an outpatient psychiatric clinic in Nigeria. Mental Health, Religion and Culture, 10(6), 609–620.
go back to reference Breen, A., Swartz, L., Joska, J., Flisher, A., & Corrigall, J. (2007). Adherence to treatment in poorer countries: A new research direction? Psychiatric Services, 58(4), 567–568.PubMedCrossRef Breen, A., Swartz, L., Joska, J., Flisher, A., & Corrigall, J. (2007). Adherence to treatment in poorer countries: A new research direction? Psychiatric Services, 58(4), 567–568.PubMedCrossRef
go back to reference Federal Ministry Of Health. (1990). The national policy on mental health for Nigeria. Lagos, Nigeria: Federal Ministry of Health (FMOH). Federal Ministry Of Health. (1990). The national policy on mental health for Nigeria. Lagos, Nigeria: Federal Ministry of Health (FMOH).
go back to reference Fleck, D. E., Keck, P. E., Corey, K. B., Jr., & Strakowski, S. M. (2005). Factors associated with medication adherence in African American and white patients with bipolar disorder. Journal of Clinical Psychiatry, 66(5), 646–652.PubMedCrossRef Fleck, D. E., Keck, P. E., Corey, K. B., Jr., & Strakowski, S. M. (2005). Factors associated with medication adherence in African American and white patients with bipolar disorder. Journal of Clinical Psychiatry, 66(5), 646–652.PubMedCrossRef
go back to reference Goldman, H. H., Skodol, A. E., & Lave, T. R. (1992). Revising axis V for DSM-IV: A review of measures of social functioning. American Journal of Psychiatry, 149, 1148–1156.PubMed Goldman, H. H., Skodol, A. E., & Lave, T. R. (1992). Revising axis V for DSM-IV: A review of measures of social functioning. American Journal of Psychiatry, 149, 1148–1156.PubMed
go back to reference Gureje, O. (2003). Revisiting the national mental health policy for Nigeria. Archives of Ibadan Medicine, 4(1), 2–4. Gureje, O. (2003). Revisiting the national mental health policy for Nigeria. Archives of Ibadan Medicine, 4(1), 2–4.
go back to reference Helen, K., Sube, B., Michael, K., & Margaret, L. (2000). Prospective controlled study of psychotic out-patient non-attendance. Characteristics and outcome. British Journal of Psychiatry, 176, 160–165.CrossRef Helen, K., Sube, B., Michael, K., & Margaret, L. (2000). Prospective controlled study of psychotic out-patient non-attendance. Characteristics and outcome. British Journal of Psychiatry, 176, 160–165.CrossRef
go back to reference Ikwuagwu, P. U., Nafziger, J. C., Ihezue, U. H., & Ohaeri, J. U. A. (1994). study of the social and clinical characteristics of in-patients at a psychiatric unit in northern Nigeria. West African Journal of Medicine, 13(4), 191–195.PubMed Ikwuagwu, P. U., Nafziger, J. C., Ihezue, U. H., & Ohaeri, J. U. A. (1994). study of the social and clinical characteristics of in-patients at a psychiatric unit in northern Nigeria. West African Journal of Medicine, 13(4), 191–195.PubMed
go back to reference Jones, D. T. (1987). A survey of hospital out-patient referral rates, Wales, 1985. British Medical Journal, 295, 734–736.CrossRef Jones, D. T. (1987). A survey of hospital out-patient referral rates, Wales, 1985. British Medical Journal, 295, 734–736.CrossRef
go back to reference Koch, A., & Gillis, L. S. (1991). Non-attendance of psychiatric out-patients. South African Medical Journal, 80, 289–291.PubMed Koch, A., & Gillis, L. S. (1991). Non-attendance of psychiatric out-patients. South African Medical Journal, 80, 289–291.PubMed
go back to reference Kruse, G. R., & Rohland, M. B. (2002). Factors associated with attendance at a first appointment after discharge from a psychiatric hospital. Psychiatric Services, 53, 473–476.PubMedCrossRef Kruse, G. R., & Rohland, M. B. (2002). Factors associated with attendance at a first appointment after discharge from a psychiatric hospital. Psychiatric Services, 53, 473–476.PubMedCrossRef
go back to reference Makanjuola, R. O. A. (1985). Clinical and socio-cultural parameters in Nigerian psychiatric patients: A prospective study. Acta Psychiatrica Scandinavica, 72, 512–521.CrossRef Makanjuola, R. O. A. (1985). Clinical and socio-cultural parameters in Nigerian psychiatric patients: A prospective study. Acta Psychiatrica Scandinavica, 72, 512–521.CrossRef
go back to reference Martin, K., Derek, K., Klaus, P., & Pablo, L. (2004). Non-adherence to antipsychotic medication regimens: Association with resource use and costs. British Journal of Psychiatry, 184, 509–516.CrossRef Martin, K., Derek, K., Klaus, P., & Pablo, L. (2004). Non-adherence to antipsychotic medication regimens: Association with resource use and costs. British Journal of Psychiatry, 184, 509–516.CrossRef
go back to reference Mcglade, K. J., Bradley, T., & Murphy, G. J. (1988). Referrals to hospital by general practitioners: A study of compliance and communication. British Medical Journal, 297, 1246–1248.PubMed Mcglade, K. J., Bradley, T., & Murphy, G. J. (1988). Referrals to hospital by general practitioners: A study of compliance and communication. British Medical Journal, 297, 1246–1248.PubMed
go back to reference Nelson, A. E., Maruish, M. E., & Axler, J. L. (2000). Effect of discharge planning and compliance with outpatient appointments on readmission rates. Psychiatric Services, 51, 885–889.PubMedCrossRef Nelson, A. E., Maruish, M. E., & Axler, J. L. (2000). Effect of discharge planning and compliance with outpatient appointments on readmission rates. Psychiatric Services, 51, 885–889.PubMedCrossRef
go back to reference Nusrat, H. R., & Muhammad, A. (2002). Non-compliance to medication in psychiatric patients. Pakistan Journal of Medical Science, 189(1), 52–54. Nusrat, H. R., & Muhammad, A. (2002). Non-compliance to medication in psychiatric patients. Pakistan Journal of Medical Science, 189(1), 52–54.
go back to reference Odejide, A. O., Olatawura, M. O., & Makanjuola, R. O. A. (1978). A psychiatric service in a Nigerian general hospital. African Journal of Psychiatry, 4, 97–102. Odejide, A. O., Olatawura, M. O., & Makanjuola, R. O. A. (1978). A psychiatric service in a Nigerian general hospital. African Journal of Psychiatry, 4, 97–102.
go back to reference Ojeshina, J. O. (1979). Some social and psychological problems of schizophrenics in Nigeria. African Journal of Psychiatry, 5, 97–101. Ojeshina, J. O. (1979). Some social and psychological problems of schizophrenics in Nigeria. African Journal of Psychiatry, 5, 97–101.
go back to reference Olfson, M., Mechanic, D., Stephen, H., Boyer, C. A., Walkup, J., & Weiden, J. P. (2000). Predicting medication non-compliance after hospital discharge among patients with schizophrenia. Psychiatric Services, 51, 216–222.PubMedCrossRef Olfson, M., Mechanic, D., Stephen, H., Boyer, C. A., Walkup, J., & Weiden, J. P. (2000). Predicting medication non-compliance after hospital discharge among patients with schizophrenia. Psychiatric Services, 51, 216–222.PubMedCrossRef
go back to reference Overall, J. E., & Gorham, D. R. (1962). The Brief Psychiatric Rating Scale (BPRS). Psychological Reports, 10, 799–812.CrossRef Overall, J. E., & Gorham, D. R. (1962). The Brief Psychiatric Rating Scale (BPRS). Psychological Reports, 10, 799–812.CrossRef
go back to reference Pecoul, B., Chirac, P., Trouiller, P., & Pinel, J. (1999). Access to essential drugs in developing countries. A lost battle? Journal of the American Medical Association, 281, 361–367.PubMedCrossRef Pecoul, B., Chirac, P., Trouiller, P., & Pinel, J. (1999). Access to essential drugs in developing countries. A lost battle? Journal of the American Medical Association, 281, 361–367.PubMedCrossRef
go back to reference Perkins, D. O. (2002). Predictors of non-compliance in patients with schizophrenia. Journal of Clinical Psychiatry, 63, 1121–1128.PubMed Perkins, D. O. (2002). Predictors of non-compliance in patients with schizophrenia. Journal of Clinical Psychiatry, 63, 1121–1128.PubMed
go back to reference Rettenbacher, M. A., Hofer, A., Eder, U., Hummer, M., Kemmler, G., Weiss, E. M., et al. (2004). Compliance in schizophrenia: Psychopathology, side effects, and patients’ attitudes toward the illness and medication. Journal of Clinical Psychiatry, 65(9), 1211–1218.PubMed Rettenbacher, M. A., Hofer, A., Eder, U., Hummer, M., Kemmler, G., Weiss, E. M., et al. (2004). Compliance in schizophrenia: Psychopathology, side effects, and patients’ attitudes toward the illness and medication. Journal of Clinical Psychiatry, 65(9), 1211–1218.PubMed
go back to reference Silverstone, T., & Turner, P. (1995). Social and psychological aspects of drug treatment. In T. Silverstone & P. Turner (Eds.), Drug Treatment in Psychiatry (5th ed., pp. 81–96). London: Rutledge. Silverstone, T., & Turner, P. (1995). Social and psychological aspects of drug treatment. In T. Silverstone & P. Turner (Eds.), Drug Treatment in Psychiatry (5th ed., pp. 81–96). London: Rutledge.
go back to reference SPSS For Windows. (2001). Version 11.0.0. Chicago, IL: SPSS Inc. SPSS For Windows. (2001). Version 11.0.0. Chicago, IL: SPSS Inc.
go back to reference The World Health Organization (WHO). (1992). The ICD–10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization (WHO). The World Health Organization (WHO). (1992). The ICD–10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization (WHO).
go back to reference Thornicroft, G., & Tansella, M. (2004). Components of a modern mental health service: a pragmatic balance of community and hospital care. Overview of systematic evidence. British Journal of Psychiatry, 185, 283–907.PubMedCrossRef Thornicroft, G., & Tansella, M. (2004). Components of a modern mental health service: a pragmatic balance of community and hospital care. Overview of systematic evidence. British Journal of Psychiatry, 185, 283–907.PubMedCrossRef
go back to reference Weiden, P., & Olfson, M. (1995). The cost of relapse in schizophrenia. Schizophrenia Bulletin, 21, 419–442.PubMed Weiden, P., & Olfson, M. (1995). The cost of relapse in schizophrenia. Schizophrenia Bulletin, 21, 419–442.PubMed
go back to reference Zygmunt, A., Olfson, M., Carol, A., & Mechanic, D. (2002). Interventions to improve medication adherence in schizophrenia. American Journal of Psychiatry, 159, 1653–1664.PubMedCrossRef Zygmunt, A., Olfson, M., Carol, A., & Mechanic, D. (2002). Interventions to improve medication adherence in schizophrenia. American Journal of Psychiatry, 159, 1653–1664.PubMedCrossRef
Metadata
Title
Prospective Study of Psychiatric Follow-up Default and Medication Compliance after Discharge at a Psychiatric Hospital in Nigeria
Authors
A. B. Adeponle
A. S. Baduku
M. L. Adelekan
G. T. Suleiman
S. O. Adeyemi
Publication date
01-02-2009
Publisher
Springer US
Published in
Community Mental Health Journal / Issue 1/2009
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-008-9155-6

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