Study of the factors influencing the non-adherence to treatment in a psychiatric population in Bingerville, Côte d'Ivoire

Background: Poor adherence to treatment is a worrying phenomenon that affects many patients worldwide. It can seriously compromise the effectiveness of treatment, leading to worsening symptoms, frequent hospitalizations and even reduced life expectancy.

Objective: To identify factors leading to non-compliance with medication in psychiatric patients.

Methods: This is a cross-sectional analytical study took place from 6 January to 3 February 2020 at Bingerville Psychiatric Hospital. It was conducted with 60 patients.

Sociodemographic data was collected from patients using their medical records. Medication adherence was assessed using Thompson's MARS (Medication Adherence Rating Scale).

Results: Patients with a secondary education were the least compliant (61.90%), followed by those with a university education (16.67%) and those with no education (11.90%). Patients with primary education were the least compliant, at 9.52%. These differences are not significant (X² = 1.15, p = 0.2827). Of the 42 non-compliant patients, 61.90% were unemployed (26 cases). 4.76% were civil servants, 2.38% were self-employed and 30.95% worked in other sectors. These differences are not statistically significant (X² = 1.15, p = 0.2827). Among the non-respondents, 88.10% were single, 7.14% were cohabiting, or married and 2.38% were divorced or widowed. These differences are significant (X²= 15.78, p= 0.0001).

Conclusion: To improve the monitoring of psychiatric treatment in Côte d'Ivoire, a larger sample size should be included, and the questionnaires should be adapted to reflect African realities. This should consider socio-demographic, ethno-social and spiritual factors. Studies could also explore the relationship between the type of disorder and the therapeutic alliance.