The study of prevalence and factors associated with medication nonadherence in child and adolescent psychiatric department, Nakorn Nayok Hospital
Main Article Content
Objective: To determine the prevalence and associated factors of medication nonadherence among children and adolescent psychiatric patients at Nakhon Nayok Hospital.
Method: A cross-sectional descriptive study was conducted on 71 children and adolescent psychiatric patients aged 5 - 18 years old. The sample population were patients at the child and adolescent psychiatry out-patient clinic at Nakhon Nayok Hospital from January to April 2022. The demographic data and the medication histories of both the parents and their children were collected and analysed.
Result: From the analysis of the 71 subjects (63.4% were male) with a mean age of 11.9±4.1 years. Most were studying at the secondary school level (50.7%) and were diagnosed with attention deficit hyperactivity disorder (56.3%). The most prescribed medication was methylphenidate (56.3%) and the average duration of the treatment was 20.0±14.9 months. The prevalence of medication nonadherence was 49.3%. The most common causes of medication nonadherence were forgetfulness (28.1%), unattendance to follow up the appointment (21.1%) and refusal to take medication (15.5%), respectively. Medication adherence were statistically significant with age 5 - 10 years (p-value = 0.03) and were resident in Nakhon Nayok Province (p-value = 0.03). Factors associated with medication nonadherence were not found.
Conclusion: The results should be used to determine risk factors and to develop tools to improve medication adherence in child and adolescent psychiatric patients.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ส่งมาลงตีพิมพ์ในวารสารสมาคมจิตแพทย์ ต้องไม่เคยตีพิมพ์หรือได้รับการตอบรับให้ตีพิมพ์ในวารสารฉบับอื่น และต้องไม่อยู่ระหว่างการส่งไปตีพิมพ์ในวารสารอื่น
Sadock B.J, Sadock VA, Ruiz P. Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 11th ed. Philadelphia: Wolters Kluwer; 2015. p. 918,1090,1117-1118
Lotrakul M, Sukanit P. Ramathibodi’s Essential of Psychiatry. 4th ed. Bangkok: Faculty of Medicine Ramathibodi Hospital 2015. p.16, 22-26.
Sthapornnanon N. Medication non adherence. Thai Pharm Health Sci J 2012;7(1):1-14
Kongkaew C. Patients’medication taking behavior: critiques of relevant terminologies. Thai Pharm Health Sci J 2011;6(4):299-302
Tantipiwattanaskul K. A study of drug related problems in child and adolescent with mental health problem. Journal of Health Science 2019; 28: 986-95.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005; 353: 487-97.
Gajria K, Lu M, Sikirica V, Greven P, Zhong Y, Qin P, et al. Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder - a systematic literature review. Neuropsychiatr Dis Treat 2014; 10: 1543-69.
Gau SS, Chen SJ, Chou WJ, Cheng H, Tang CS, Chang HL, et al. National survey of adherence, efficacy, and side effects of methylphenidate in children with attention-deficit/hyperactivity disorder in Taiwan. J Clin Psychiatry 2008; 69: 131-40
Paes AH, Bakker A, Soe-Agnie CJ. Measurement of patient compliance. Pharm World Sci 1998; 20: 73-7.
Forbes CA, Deshpande S, Sorio-Vilela F, Kutikova L, Duffy S, Gouni-Berthold L, et al. Systematic literature review comparing methods for the measurement of patient persistence and adherence. Curr Med Res Opin 2018; 34(9): 1613-25.
Karve S, Cleves MA, Helm M, Hudson TJ, West DS, Martin BC. Good and poor adherence: optimal cut-point for adherence measures using administrative claims data. Curr Med Res Opin 2009; 25: 2303-10.
Rapoff MA. Adherence to pediatric medical regimens. 2th ed. New York: Springer Science Business; 2010.
Samakkeethum O, Danwilai K. Assessment of adherence in children nephrotic syndrome at outpatient Pharmacy Queen Sirikit National Institute of Child Health. Journal of the Department of Medical Service 2017; 42(6): 88-95
Hage A, Weymann L, Bliznak L, Marker V, Mechler K, Dittmann RW. Non-adherence to psychotropic medication among adolescents - a systematic review of the literature. Z Kinder Jugendpsychiatr Psychother 2018; 46(1): 69-78
Bener A, Dafeeah EE, Salem MO. A study of reasons of non-compliance of psychiatric treatment and patients’ attitudes towards illness and treatment in Qatar. Issues Ment Health Nurs 2013; 34: 273-80.
Both C, Mechler K, Niemeyer L, Jennen-Steinmetz C, Hohmann S, Schumm L, et al. Medication adherence in adolescents with psychiatric disorders. Z Kinder Jugendpsychiatr Psychother 2021; 49(4): 295-306.
Dinnissen M, Dietrich A, Vander Molen JH, Verhallen AM, Buiteveld Y, Jongejan S, et al. Prescribing antipsychotics in child and adolescent psychiatry: guideline adherence. Eur Child Adolesc Psychiatry 2020; 29(12): 1717-27.
Sanchez M, Lytle S , Neudecker M, McVoy M. Medication adherence in pediatric patients with bipolar disorder: a systematic review. J Child Adolesc Psychopharmacol 2021; 31(2): 86-94.
Frank E, Ozon C, Nair V, Othee K. Examining why patients with attention-deficit/hyperactivity disorder lack adherence to medication over the long term: a review and analysis. Clin Psychiatry 2015; 76(11): 1459-68.
Oliva V, Lippi M, Paci R, Fabro LD, Delvecchio G, Brambilla P, et al. Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder -a systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109.
Athipongarporn A, Limsuwan N. Reasons of poor treatment adherence in children and adolescents with ADHD. J Psychiatr Assoc Thailand 2018; 63(1): 33-46
Wehmeier PM, Dittmann RF, Banaschewski T. Treatment compliance or medication adherence in children and adolescents on ADHD medication in clinical practice: results from the COMPLY observational study. Atten Defic Hyperact Disord 2015; 7(2): 165-74.
Alfageh BH, Wang Z, Mongkhon P, Besag FM, Alhawassi TM, Brauer R. Safety and tolerability of antipsychotic medication in Individuals with autism spectrum disorder: a systematic review and meta-analysis. Paediatr Drugs 2019; 21(3): 153-67.
Cramer JA, Rosenheck R. Compliance with medication regimens for mental and physical Disorders. Psychiatr Serv 1998;49(2):196-201.
Wu SH, Wang K, Chen Y, Wang WQ, Wang F, Montgomery W, et al. Exploratory analysis of early treatment discontinuation and clinical outcomes of patients with attention-deficit/hyperactivity disorder. Asia Pac Psychiatry 2017; 9(1).
Tantipanjaporn P, Kiatrungrit K. Factors associated with medication adherence in adolescents with ADHD. J Psychiatr Assoc Thailand 2016; 61: 131-44.
Ninlanon K, Sakulbumrungsil R, Phattanarudee S, Tan-khum T. Factors affecting methylphenidate adherence in children and adolescent with attention deficit hyperactivity disorder. Journal of Mental Health of Thailand 2015; 23(1):1-11.
Pimratana W. Caretakers’ knowledge of attention deficit hyperactivity disorder (ADHD) and child patients’ compliance to take methylphenidate (MPH). J Psychiatr Assoc Thailand 2016; 61(1): 15-26.
Wayne WD. Biostatistics: a foundation of analysis in the health sciences (6thed). John Wiley&Sons, Inc; 1995.
Dean AJ, Wragg J, Draper J, Mcdermott BM. Predictors of medication adherence in children receiving psychotropic medication. J Paediatr Child Health 2011; 47(6): 350-5.
Hamrin V, McCarthy E, Tyson V. Pediatric psychotropic medication initiation and adherence: a literature review based on social exchange theory. J Child Adolesc Psychiatr Nurs 2010; 23(3): 151-72.
Department of Provincial Administration, Ministry of the Interior. Statistics, population and house statistics for the year 2021. [updated December ,2021; cited 2022 May 24]. available from: https://stat.bora.dopa.go.th/new_stat/webPage/statByYear.php
Sitholey P, Agarwal V, Chamoli S. A preliminary study of factors affecting adherence to medication in clinic children with attention-deficit/hyperactivity disorder. Indian J Psychiatry 2011; 53: 41–4.
Solmi M, Miola A, Croatto G, Pigato G, Favaro A, Fornaro M, et al. How can we improve antidepressant adherence in the management of depression? -a targeted review and 10 clinical recommendations. Braz J Psychiatry 2021; 43(2): 189-202.
Timlin L, Hakko H, Kyngas H. Factors that affect adolescent adherence to mental health and psychiatric treatment: a systematic Integrative review of the literature. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology 2014; 3(2): 99-107.
Edgcomb JB, Zima BJ. Medication adherence among children and adolescents with severe mental Illness: a systematic review and meta-analysis. Child Adolesc Psychopharmacol 2018; 28(8): 508-20.
McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions. JAMA 2002; 288: 2868-79.