How people diagnosed with schizophrenia explain their noncompliance with prescribed medications

Michael Charles Rubin (1996)

Medication noncompliance among psychiatric outpatients accounts for a significant number of hospital readmissions. Only one previous study (Pool & Elder, 1985) was found that asked noncomplying people diagnosed with Schizophrenia why they stopped taking prescribed medications. The present study replicated the Pool and Elder (1985) study. Forty people diagnosed with Schizophrenia and Schizoaffective Disorder who had been rehospitalized and noncompliant with medications were administered the true false questionnaire used in the previous study. Frequency data were analyzed for the entire sample and three subgroups based on: Gender, Age (over 36 y.o. and under 36 y.o.), and Diagnosis (Schizophrenia/Schizoaffective Disorder). In addition, a factor analysis determined which combinations of reasons the entire sample and subgroups identified as why they stopped taking medications. Factor Analysis organized the reasons for stopping medications into 5 factors; (1) Side Effects, (2) Low Risk/Benefit Ratio, (3) Mistrust of Treatment Setting, (4) Social/Vocational Interference, and (5) Negative Support System. Side Effects were the most common groups of reasons in the entire sample. Factor 1 was significant in the Gender and Age subgroups. Females were more likely to stop medications due to side effects than were males and younger subjects were more likely to stop medications due to side effects than were older subjects. Factor 4 was found to be significant in the Age and Diagnosis subgroups. Younger subjects were more likely to stop medications due to social/vocational reasons than were older subjects and subjects diagnosed with Schizoaffective disorder were more likely to identify social/vocational reasons for noncompliance than were subjects diagnosed with Schizophrenia. The results of this study indicate that pharmacological efforts to minimize side effects over the 10 years since the Pool and Elder (1985) study, have had minimal effect. Side effects continues to be the primary reason people with Schizophrenia fail to take medications. In addition, the results of this study will be useful to clinicians to the extent that demographic subgroups will require different areas of attention when teaching about medication.