Factors Affecting the Treatment Compliance in

Psychiatric Setting; Retrospective Study

Yasirah Gohar
Clinical Psychologist & In Charge Rehabilitation
Karwan E Hayat
• The use of medicine therapy is to achieve better outcome in the concerned
patients. However, despite all the best efforts of the healthcare professionals,
treatment outcomes might not be achievable if the patients are non-complaint.
Hence, there is a need to analyze the factors that contribute to non-compliance.
• The therapeutic relationship in term of compliance not only includes
medication but also includes diet, exercise, or life style changes. The number of
studies have been conducted in developed countries regarding therapeutic non-
compliance( Jin, J., Sklar,G.E., et al., 2008) .

• The estimated rate of long-term medication therapies complains was between 40%
and 50% (DiMatteo MR,2004).
•  It is estimated that 50% of chronic psychiatric patients are not taking medication
as prescribed after six months (World Health Organization; 2003).
• It was hypothesized that there are multiple factors which
play important role in the treatment compliance of the
psychiatric patients who were getting treatment from
Karwan-e-Hayat.
• The factors explored in this study to be responsible for the
treatment compliance were gender, socio economic status
and education.
• This type of retrospective study is conducted for the first time
at KEH which will open the room for future studies in
exploring more variables responsible for treatment
compliance
 Objective

• To evaluate the multiple factors

associated with adherence to the
treatment with severe mental
illness in the psychiatric patients
 Research Design

• A cross- sectional retrospective

study. Data was selected from
Karwan e Hayat.
 Method

• The Study includes the data set of Hospital Management

System(HMS) Karwan e Hayat from Jan 2007 to Dec 2016.
• A total of 1564 patients, age between 18 to 65 years were
selected through convenient sampling from inpatient and
outpatient clinics for this study.
• The data record composed of gender, socio economic
status and education.
 Inclusion Criteria

1. Data were selected from Jan 2007- Dec 2016

2. Age rang between 18- 70 years

3. Both in and out patients were selected

4. All Psychiatric disorder

 Exclusion Criteria

1. Incomplete data profile.

2. Neurological disorders
 Gender Profile

35%
Female
Male

65%
 Education profile

2% 5%
8%
31%
Masters
Bachelors
19% Intermediate
Matric
Primary
Secondary
Un-educated
17%
19%
 Results

t-test Report of Qualification

Paired Differences

95% Confidence Interval of the

  Difference

Qualification Mean Std. Deviation Std. Error Mean Lower Upper t df Sig. (2-tailed)

Bachelors Pair 1 First - Last -.143 1.073 .122 -.386 .101 -1.169 76 .246

Intermediate Pair 1 First - Last -.180 1.061 .094 -.365 .006 -1.917 127 .058

Masters Pair 1 First - Last -.192 1.059 .208 -.620 .235 -.926 25 .363

Matric Pair 1 First - Last -.212 1.043 .061 -.333 -.092 -3.477 291 .001

Primary Pair 1 First - Last -.079 1.021 .060 -.196 .039 -1.319 291 .188

Secondary Pair 1 First - Last -.056 1.000 .061 -.177 .064 -.918 266 .360

Un-educated Pair 1 First - Last -.199 .983 .045 -.287 -.111 -4.448 481 .000

Baseline data of gender Medicine Compliance Follow up data of gender Medicine Compliance

Gender No.of patients Percent Gender No.of patients Percent

Female   1 70 12.9 Female   1 45 8.3

2 245 45.3 2 212 39.2

3 197 36.4 3 229 42.3

4 29 5.4 4 55 10.2

Total 541 100.0 Total 541 100.0

Male   1 140 13.7     1 112 10.9

2 444 43.4 2 410 40.1

3 386 37.7 3 412 40.3

4 53 5.2 4 89 8.7

Total 1023 100.0 Total 1023 100.0

 t-test report of Socioeconomic status

Paired Differences

95% Confidence Interval of the

  Difference

Socioeconomic status Mean Std. Deviation Std. Error Mean Lower Upper t df Sig. (2-tailed)

High Socioeconomic Pair 1 First – Last -.324 1.070 .104 -.531 -.117 -3.102 104 .002

low Socioeconomic Pair 1 First – Last -.138 1.012 .026 -.190 -.086 -5.200 1458 .000

• The Medication Compliance Scale indicates that the 57.1% male and
47.5% female showed adherence to treatment. Uneducated patients
were at higher risk of being non-adherent as compared to high
educated patients (P=0.00).There were no difference seen between
high socioeconomic group and low socioeconomic group in non-
adherence
 Conclusion

• The study highlighted that education and gender are one of

the factors that contributed to therapeutic non-compliance
in psychiatric setting.

• The gender differences in psychiatry is widely acknowledged,

especially its relevance for a better understanding of several
biological and psychosocial risk factors such as response to
treatment. Data revealed gender differences in terms of
incidence rates such as females have shown less adherence
to treatment a compared to males at Karwan-e-Hayat.
• Similarly educated patients showed comparatively better
treatment compliance as compared to un educated patients.