Medication Adherence and Patients Satisfaction among Psychiatric Outpatients in a Rural Nigerian Tertiary Healthcare Facility Joseph O Fadare*, Musiliu A Lawal, Adetokunbo O Elegbede, David O Joseph, Bolawale A Ampitan Majekodunmi L Ayodele Department of Pharmacology, Ekiti State University, Ado-Ekiti, Nigeria *Corresponding author: Joseph O Fadare, Department of Pharmacology, Ekiti State University, Ado-Ekiti, Nigeria, Tel: +234-8138048127; E-mail: mailto:jofadare@gmail.com Received date: March 25, 2014, Accepted date: May19, 2014, published date: May 25, 2014 Copyright: © 2014 Joseph O Fadare, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction Adherence in mental disorders is a bit different from that in other medical conditions because of some peculiarities associated with these disorders. A major factor that may contribute to non-adherence is the satisfaction or otherwise of the patients to the treatment being received from the health care provider. The main objective of this study was to determine the level of adherence and treatment satisfaction among psychiatric patients in a rural healthcare facility in South-West Nigeria. Methods This cross-sectional study used the 8-item Morisky Medication Adherence Scale (MMAS-8) and the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4) to assess the adherence and patient satisfaction respectively. Results A total of 100 patients participated in the study out of which 57 (57%) were males and 43 (43.%) female with a mean age was 37 ± 12.8years. Schizophrenia was the most common diagnosis (67%) found among the study participants. Forty-five (45.9%) patients scored high for adherence, 34 (34.7%) had medium score while 19 (20.4%) scored low. Among patients with schizophrenia, 23 (39%) had high adherence, 26 (44.1%) medium and 10 (16.9%) low adherence. The scoring of the Treatment Satisfaction Questionnaire administered to the patients was done according to the interpretation key. The mean Effectiveness Score was 74.3 ± 15.6, Side-Effects (86.6 ± 24.4), Convenience (73.1 ± 12.8) and Satisfaction (73.5 ±15.7). The mean satisfaction score of patients with schizophrenia was 73.5 ± 14.8 while the score for all other diagnoses (grouped as one) was 74.4 ± 16.5. Conclusion Medication Adherence and Treatment Satisfaction among psychiatric outpatients in a rural Nigerian hospital is good. There is however a need to sustain and even improve on this outcome through better therapeutic alliance with patients and education on the nature of adverse drug reactions to prescribed drugs. Keywords: Medication compliance; Mental disorders; Psychiatric patients Introduction Adherence to a medication can be defined as the extent to which a patient follows instructions given by a physician regarding use of the prescribed medication [1]. Adherence in mental disorders is a bit different from that in other medical conditions because of some peculiarities; most mental conditions are chronic with periods of exacerbation and relapse, poor insight in conditions like schizophrenia and associated cognitive problems[2,3]. Factors that have been identified to affect adherence among psychiatric patients include living alone, fear of adverse drug reactions, perceived inefficacy of the medication, using potentially inappropriate medications and the belief that the medication is no longer needed [4,5]. The employment status of patients, level of social functioning and substance abuse are other predictors of non-adherence [6]. The consequences of non-adherence among patients with mental disorders include higher healthcare costs, frequent hospital admissions and increased mortality [7]. Several studies have reported on adherence among various categories of psychiatric patients; in a study among Palestinians patients only about 22% had a high level of adherence while two separate Nigerian studies also correlated a similar level of poor adherence [8-10]. A major factor that may contribute to non-adherence is the satisfaction or otherwise of the patients to the treatment being received from the health care provider. This relationship between adherence and treatment satisfaction has not been well explored in previous Nigerian studies. Also, the above cited Nigerian studies were conducted in mental health facilities that are located in urban centers of the country and might not have reflected the true situation in a rural Nigerian setting. The main objective of this study was to determine the level of adherence to medications among psychiatric outpatients and factors that may affect it in a rural healthcare facility in South-West Nigeria. A secondary objective of the study was to determine the level of treatment satisfaction of the patients and to investigate the relationship between the two factors Fadare et al., J Psychiatry 2014, 17:4 DOI: 10.4172/2378-5756.1000125 Research Article Open Access J Psychiatry An open access journal Volume 17 • Issue 4 • 1000125 Journal of Psychiatry J o u r n a l o f P s y c h i a t r y ISSN: 2378-5756