Psychotropic polypharmacy in Nigeria. The danger can be avoided and cost reduced

Psychotropic drug prescribing in a Nigerian psychiatric hospital

Psychopharmacotherapy dominates the therapeutic arsenal of psychiatrists and, not surprisingly, psychotropic drugs are widely consumed in psychiatric practice. The pattern of prescribing of these drugs needs to be appraised in terms of ‘rational drug use', which may be defined as ‘the use of the least number of drugs to obtain the best possible effects in the shortest possible time and at a reasonable cost’ (Gross, 1981).

Prevalence and predictors of poor medication adherence among out-patients at a psychiatric hospital in Benin City, Nigeria

OBJECTIVE

To determine the prevalence and predictors of poor or non-compliance with medications among respondents attending an adult psychiatry out-patient clinic in Benin City, Nigeria.

METHODS

Respondents (n = 137) were randomly selected over a 3-month period using a cross-sectional study design. They were administered a questionnaire adapting the Factors Influencing Neuroleptic Medication Taking Scale as well as the Brief Psychiatric Rating Scale (BPRS) to ascertain medication, illness-related and psychosocial variables. Medication adherence was determined by self report and for the purpose of the study confined to the week prior to interview.

RESULTS

Almost half (42.3%) were poorly adherent to medications. Most admitted to good psychosocial support, but believed that their illness had a spiritual aetiology. Stigma, higher frequency of medication dosing as well as illness severity as measured by their BPRS scores were significant predictors of poor medication adherence.

CONCLUSION

The prevalence of poor medication adherence in this environment is higher than in studies from Western cultures, and replicates rates from previously published reports in this environment. Factors responsible for poor adherence can form the template for intervention studies and programs to improve compliance.