Byline: Sandeep. Grover, Subho. Chakrabarti, Aarti. Sharma, Shikha. Tyagi
Aim: To examine attitudes towards psychotropic medications among patients with chronic psychiatric disorders as well as their family caregivers by using factor analysis. Materials and Methods: The study included 200 patients and their family caregivers with chronic psychiatric disorders who are attending the psychiatry outpatient services. A self-designed 18-item self-rated questionnaire was used to evaluate the attitude toward psychotropics and factor analysis was done to study the different models of attitudes. Results: In general both patients and caregivers had positive attitude toward the psychotropic medications and there was no significant difference between the patients and caregivers on the various items of the questionnaire assessing the attitude. Factor analysis of the questionnaire indicated that either two-factor or four-factor models explained the attitude of the patients and caregivers. In the two-factor model there was one positive and one negative attitude factor, whereas the four-factor model comprised of two positive and two negative attitude factors. The four-factor model of attitudes provided a more comprehensive solution to how attitudes might be formed among patients and their family caregivers. Factors one and four in the four-factor solution still reflected positive attitudes, but appeared to portray a risk-benefit approach, in which benefits such as the efficacy of psychotropic medications in treating mental illnesses and preventing relapse, and medications being better than other options were being contrasted with the risks of side effects and permanent damage or harm. Conclusion: Attitudes of patients with chronic psychiatric disorders and their caregivers toward psychotropic medications appear to be shaped by factors such as perceived efficacy or benefit from medicines, the necessity for taking treatment and concerns such as side effects, harm or expense.
Medication non-adherence is a common and complex barrier to effective long-term treatment of chronic psychiatric disorders. Reported rates of non-adherence vary greatly across different studies of psychotic, mood and anxiety disorders, but fall somewhere within the range of 24% to 90%; on the average about half or more of the patients with these disorders are non-adherent at any given point of time. [sup],, Non-adherence has several adverse consequences. It worsens the course of the illness and leads to impaired functioning, which in turn increase the burden on the caregivers and on the society, by increasing the costs of care of chronic psychiatric disorders.
A multitude of factors can potentially influence adherence to a prescribed psychotropic medication regimen. Traditionally, studies have focused more on demographic, clinical and treatment-related factors. However, research over the past two decades or so has highlighted the contribution of patients' perspectives toward adherence. According to social, cognitive and behavioral perspectives, adherence or non-adherence is often a considered decision by people making their own choices about the benefits and disadvantages of treatment, based on their own attitudes and beliefs, their personal circumstances, and the information available to them. [sup], The construct of attitudes to medications represents a convenient proxy measure for this decision-making process on part of the patients. [sup] Therefore, it comes as no...