Personality traits and other factors associated with psychotropic medication non-adherence at two hospitals in Uganda. A cross-sectional study
Authors: Niyokwizera Emmanuel , Nitunga David , Muhumuza Joshua , Niyubahwe Raissa , Abamara Nnaemka Chukwudum , Kirabira Joseph 
Published: April 2024

Background

Mental illnesses, like other chronic illnesses, require medications for both immediate, short term and long term treatment. Medication adherence is the first and most important factor for better treatment outcome. Non-adherence to psychotropic medications is associated with relapse, readmission, and early death. The beliefs about medication which influence non-adherence to medications are moderated by specific personality traits. Sociodemographic and clinical factors can also influence non-adherence psychotropic medications. Non-adherence to psychotropic medications is high in Africa but there is paucity of published studies on the level of psychotropic medication non-adherence and associated personality traits in Uganda.

Aim

To determine the prevalence of psychotropic medication non-adherence and associated personality traits among people with mental illness attending Kampala International University Teaching Hospital (KIU-TH) and Jinja Regional Referral Hospital (JRRH).

Methods

This study employed a hospital-based cross-sectional design. 396 adult patients suffering from mental illness were collected from KIU-TH and JRRH outpatient clinics. Medication adherence was assessed using Medication Adherence Rating Scale (MARS) while personality traits were assessed by the short form of Big Five Inventory (Ten Items Personality Inventory). We first assessed sociodemographic and clinical factors influencing psychotropic medication non-adherence in our study (confounders). A questionnaire with sociodemographic and clinical information was also used. Logistic regression was used to assess personality traits and other factors associated with psychotropic medication non-adherence.

Results

The majority of the study participants were males (59.1%), from rural areas (74.2%), with secondary educational level (47.5%) and unemployed (44.9%). The prevalence of psychotropic medication was 46.21%. Poor family support (aOR= 6.915, CI=3.679-12.998, P<0.001), belief in witchcraft/sorcery (aOR=2.959, CI=1.488-5.884, P=0.002), experiencing side effects (aOR=2.257, CI=1.326-3.843, P=0.003), and substance use (aOR=4.174, CI=2.121-8.214, P<0.001) were factors significantly associated with psychotropic medication non-adherence. The personality traits significantly associated with psychotropic medication non-adherence after controlling for the confounders were neuroticism (aOR=7.424, CI=3.890-14.168, P<0.001) and agreeableness (aOR=0.062, CI=0.024-0.160, P<0.001).

Conclusion

Medication non-adherence was high. Non-adherent patients were more likely to have predominant neuroticism personality traits. Medication non-adherence was shown to be less common in individuals with agreeableness personality traits. Other factors associated with psychotropic medication non-adherence were poor social support, witchcraft beliefs, presence of side effects and substance use. Reinforced psycho-education should be given to patients with high risk of being non-adherent to psychotropic medications.