Study On Medication Compliance And Its Influencing Factors In Patients With Schizophrenia During Remission In Hubei Province

Objective:To explore the status of medication compliance and its influencing factors in remission patients with schizophrenia in Hubei Province,and to provide scientific evidence for targeted intervention measures.Methods:The Drug Compliance Attitude Rating Scale and Morisky Drug Compliance Behavior Questionnaire were used to assess medication compliance for patients with schizophrenia.Monofactor analysis of medication compliance was performed through comparisons between groups of patients and pearson correlation analysis between insight and treated attitude,social support,family care,and compliance scores.In order to explore the influencing factors of medication compliance in patients with schizophrenia,a Structural Equation Model was established to quantitatively analyze the action path and effect of influencing factors of medication compliance and Grounded theory was applied to conduct qualitative analysis of structured interview data.Results:The results showed that patients'with schizophrenia medication compliance(attitude)score was 5.50±3.23,and 171 patients had good medication compliance(attitude)accounted for 58.16%.The patients'medication compliance(behavior)score was 4.38±2.73,the good,moderate,and poor medication compliance(behavior)accounted for 15.98%,16.67%,and 67.35%,respectively by quantifying the medication compliance attitude and behavior of 294 patients with schizophrenia.The results of monofactor analysis showed that the patient's course of disease,number of relapses,adverse drug reactions,stigma,insight,social function,family care,and social support would affect patients'medication compliance(attitude)(P<0.05).The number of relapses,stigma,insight,social function,family care,and social support would affect patients'medication compliance(behavior)(P<0.05).The structural equation model fits well(x~2=28.625,P=0.193,RMSEA=0.029,CMIN/DF=1.245,and other fitting indicators of the model GFI,AGFI,NFI,TLI,CFI,IFI,RFI are all greater than 0.9).The results of Structural Equation Model analysis show that insight,social support,family care,social function,stigma,and adverse reactions can affect medication behavior through a direct path or through an indirect path of course,number of relapses,and attitude to medication.And the course of disease and the number of relapses can affect the medication behavior through the direct path or the indirect path of medication attitude.The results of Structural Equation Model analysis also show that insight,social function,family care,social support,adverse drug reactions,stigma,number of relapses,and course of disease could affect medication compliance in patients with schizophrenia,with effect values of 0.564,0.441,0.348,0.286,0.106,0.032,0.026,0.021.The influencing factors affecting medication compliance according to the degree of influence are:self-knowledge,social function,family care,social support,adverse drug reactions,stigma,number of relapses,course of disease.The results of qualitative interviews showed that the factors affecting medication compliance were economic conditions/primary drug prices,family supervision,drug side effects,social support,government assistance,insight,and the disease itself,according to the number of interview factors being extracted.Conclusion:Patients with remission in schizophrenia in Hubei Province have poor medication compliance.Factors affecting patient medication compliance may include insight and treated attitude,social function,family function,social support,adverse drug reactions,stigma,number of relapses and disease course.In order to improve the medication compliance of patients with schizophrenia,we need to improve patients'insight and treated attitude,family care and social support,reduce drug side effects,family exclusion and social discrimination.And we should strengthen the standard treatment management of patients,humanistic care of patients'families and promotion of mental health legislation in the whole society at the"micro-meso-macro"level,according to the"biological-psychological-social"medical model of schizophrenia.