Individual patient ’s behaviors , lack of social support , clinical or treatment and illness-related , and health system factors influenced psychotropic medication non-adherence .
Conclusion Psychotropic medication non-adherence was high .
It was influenced by various factors operating at different levels .
Background Major psychiatric disorders are growing public health concern that attributed 14 % of the global burden of diseases .
The management of major psychiatric disorders is challenging mainly due to medication non-adherence .
However , there is a paucity of summarized evidence on the prevalence of psychotropic medication non-adherence and associated factors .
Therefore , we aim ed to summarize existing primary studies ’ finding to determine the pooled prevalence and factors associated with psychotropic medication non-adherence .
Factors associated with treatment nonadherence among US bipolar disorder patients.
OBJECTIVE Since sustained treatment-adherence is often problematic and may limit clinical outcomes among bipolar disorder ( BPD ) patients , we sought risk factors to guide clinical prediction of nonadherence . METHODS Data were from a 2005 US national sample providing question naire responses by 131 r and omly selected prescribing psychiatrists and their adult BPD patients . We contrasted demographic and clinical factors in treatment-adherent versus nonadherent patients ( strictly defined as missing > or = 1 dose within 10 days ) in univariate analyses followed by multivariate logistic-regression modeling . RESULTS Of 429 DSM-IV BPD patients ( 79 % type-I ; 62 % women ; 17 % minorities ) , 34 % reported missing > or = 1 dose of  psychotropic medication within 10 days , 20 % missed entire daily doses at least once , and only 2.5 % missed all doses for 10 days . However , their prescribing psychiatrists considered only 6 % as treatment-nonadherent . Factors significantly associated with nonadherence in multivariate modeling ranked : alcohol-dependence > youth > greater affective morbidity > various side effects > or = comorbid obsessive-compulsive disorder > or = recovering from mania-hypomania . Unrelated were sex , diagnostic subtype , and other comorbidities . Since most patients received > or = 2 psychotropics , potential relationships between treatment-complexity and adherence were obscured . CONCLUSIONS Prevalent treatment-nonadherence among American BPD patients , and striking underestimation of the problem by prescribing clinicians may encourage increasingly complex treatment-regimens of untested value , but added expense , risk of adverse effects , and uncertain impact on treatment-adherence itself
Individual patient ’s behaviors , lack of social support , clinical or treatment and illness-related , and health system factors influenced psychotropic medication non-adherence .
Conclusion Psychotropic medication non-adherence was high .
It was influenced by various factors operating at different levels .
Background Major psychiatric disorders are growing public health concern that attributed 14 % of the global burden of diseases .
The management of major psychiatric disorders is challenging mainly due to medication non-adherence .
However , there is a paucity of summarized evidence on the prevalence of psychotropic medication non-adherence and associated factors .
Therefore , we aim ed to summarize existing primary studies ’ finding to determine the pooled prevalence and factors associated with psychotropic medication non-adherence .