Initial Medication Adherence by Psychiatric Outpatients in a General Hospital and Relevant Factors

Abstract Background: The International Society for Pharmacoeconomics and Outcomes Research proposed two types of medication adherence: initial and long-term. Initial adherence is a predictor of long-term adherence and thus is a crucial metric to explore and support. This study aimed to investigate initial medication adherence by psychiatric outpatients and relevant factors. Methods: The study surveyed psychiatric outpatients using a 30-day timely return visit rate (TRVR) after the first visit to indicate initial adherence. All participants agreed to engage in the self-designed survey and assessments of the Eysenck Personality Questionnaire (EPQ) and Symptoms Checklist-90 (SCL-90). Clients who missed timely return visits received telephone follow-up to determine the main reasons. Results: The overall TRVR was 59.4%, and 40.6% of clients missed return visits. Logistic regression analysis revealed risk factors for initial adherence were work, tense family atmosphere, negative attitudes towards medication, higher EPQ psychoticism score, and lower SCL-90 phobic anxiety score. The main reasons given for non-timely return visits were improvement suggesting lack of need for a return visit, various limitations, no improvement, and side effects. Conclusion: Psychiatric outpatients had poor initial medication adherence related to multiple dimensional factors, including job, family, personality characteristics, mental status, and thoughts about mental illness and treatments.