Effectiveness of Caregiver Intervention for Improving Medication Adherence on Level of Medication Adherence and Attitude toward Medications among Nonadherent Patients with Mental Illness

Abstract

Abstract Background: Nonadherence to medication is the major challenge in treating mental illness, resulting in worsening symptoms and prolonging the course of the illness. Caregivers spend a considerable amount of time with the patients. Therefore, proper training and education for caregivers help to improve treatment outcomes. Aim: This study aims to evaluate the effectiveness of caregiver intervention for improving medication adherence (CIIMA) on level of medication adherence and attitude toward medications among nonadherent patients with mental illness. Methods: This study was an experimental study using a randomized pretest posttest control group design. The study was conducted in the psychiatric outpatient department of tertiary care hospital in the eastern India. Eighty nonadherent patients with mental illness and their primary caregivers were randomly allocated to the experimental and control group using the concealment allocation method. Patients were assessed for their level of medication adherence using medication adherence rating scale, their attitude toward medication were assessed using drug attitude inventory and reasons for medication nonadherence were assessed using the Rating of Medication Influence. CIIMA consisted of individual psycho-education, pill card monitoring, weekly telephonic and text reminders provided to the experimental group, and routine treatment was provided to the control group. The level of medication adherence and attitude toward medication were reassessed for both groups after 1 month of the initial assessment. Results: After 1 month of CIIMA, 87.2% of patients in the experimental group were adherent to medication as compared 18.4% in the control group (P < 0.001), significant improvement in their attitude toward medication and treatment in the experimental group as compared to the control group (P = 0.001). Conclusion: CIIMA is an effective, low-cost, nurse-led intervention can be delivered in the inpatient and outpatient units for improving medication adherence thereby preventing future relapse of their mental illness.