Non-compliance with psychotropic medication.

Abstract

A 2-year follow-up study of 406 patients discharged from a psychiatric hospital revealed that non-compliance with psychotropic medication was a problem in at least half the cases overall. Non-compliance with oral phenothiazine was particularly evident among the cohorts of patients classified as black and coloured (approximately two-thirds and half respectively failing to comply, compared with approximately one-quarter in the white cohort). Compliance was somewhat better for intramuscular medication. The proportion of poor compliers remained at about the same level at the 6-month, 18-month and 24-month follow-ups. There were more male than female non-compliers (51% and 41% respectively) and more among younger patients of all population groups. Understanding of the details of treatment by the relatives of black and coloured patients was particularly poor, only 14% and 12% respectively understanding the purpose and nature of medication. The main reasons for non-compliance were active resistance to taking medication, unpleasant side-effects and non-attendance at clinics. Several areas which allow remediation of the problem have been highlighted.