Medication non-adherence and Disability among patients with Bipolar Disorder at a Nigerian Neuro-psychiatric Hospital

Shamsuddini Abdulsalam Inuwa; Bamidele Issa Lubuola; Marufah Dupe Lasisi; Yakubu Anas Ibrahim; Abdulkadir Usman Sambo; Ibrahim Aliyu Musa; Abubakar Sulaiman Baguda; Abdulaziz Hadi Ibrahim; Sunday John

doi:10.5455/EJSRR.20251026055913

Abstract
Background: Bipolar disorder is an episodic form of mental illness associated with debility that affects millions of people worldwide. Although its natural course could include periods in which patients have remarkable improvement, medications are used in its management. However, these medications are often not taken by the patients as prescribed, which negatively affects the outcome of the management, worsening disability.
Aim: To determine the prevalence of medication non-adherence, its association with disability, and its predictors among outpatients with bipolar disorder at Federal Neuropsychiatric Hospital, Kaduna, Kaduna State, Nigeria.
Methods: In this cross-sectional study, a total of 210 participants were recruited using consecutive sampling. Mini International Neuropsychiatric Interview (M.I.N.I.) Version 7.0.2 was used to confirm their diagnoses, following which the Sociodemographic and Clinical Characteristics Questionnaire, an 8-Item Morisky Medication Adherence Scale (MMAS-8), and the World Health Organization Disability Assessment Schedule version 2 (WHODAS 2.0) were administered. The data was analyzed using IBM SPSS version 25.0.
Results: The prevalence of medication non-adherence was 46.2%, and there exists an association between medication non-adherence and disability (ꭓ² = 32.651, df = 1, p = <0.001). Age at onset of illness below 20 years, partial insight, and poor therapeutic relationship with physicians were associated with medication non-adherence. However, only partial insight was identified as a predictor of medication non-adherence among the study participants (p < 0.001, Odds Ratio = 3.565).

Key words: Medication Adherence, Disability, Bipolar Disorder, Hospital, Nigeria