title: Incidence and factors associated with medication nonadherence in patients with mental illness: a cross-sectional study.
abstract: BACKGROUND
  In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients.
  
  
  METHODS
  A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD)-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS).
  
  
  RESULTS
  Of the 400 patients, 172 (43%) were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001), number of drugs (P = 0.002), family income (P = 0.013), and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32%) and disease-related factors (31%).
  
  
  CONCLUSIONS
  The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.
authors.forename: J M
authors.initials: JM
authors.lastname: Lucca
authors.affiliation: Department of Pharmacy Practice, JSS College of Pharmacy, JSS University, Mysore, Karnataka, India.
authors.forename: M
authors.initials: M
authors.lastname: Ramesh
authors.forename: G
authors.initials: G
authors.lastname: Parthasarathi
authors.forename: D
authors.initials: D
authors.lastname: Ram
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D001523:Mental Disorders / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012307:Risk Factors; D017678:Sex Distribution; D012944:Social Support; D055815:Young Adult; D016903:Drug Monitoring