Adherence to antipsychotic medication in indigenous patients with schizophrenia

Abstract

Introduction. Non-adherence to antipsychotic medication remains a complex problem in the treatment of schizophrenia patients, especially in indigenous population.

Objective. The aim of the study was to assess the differences in drug adherence, measured by the attitude towards the antipsychotics among Aymara and Non-Aymara patients with schizophrenia.

Method. The sample consisted of patients receiving treatment in the Mental Health Public Services in Bolivia (32.8%), Peru (33.6%) and Chile (33.6%). We used the Drug Attitude Inventory (DAI-10); the Barnes Akathisia Scale (BAS), as a measure of side effects, and the Positive and Negative Syndrome Scale (PANSS) to assess the severity of the disorder.

Results. The findings showed that Aymara patients present less adherence than Non-Aymara people; however, these differences were not significant (t = 1.29; p = 0.19). The severity of the disorder, as well as the age, showed a significant association with adherence, revealing that younger patients and with greater symptoms presented a more negative attitude toward the drugs.

Discussion and conclusion. The lack of significant differences between the groups responds to three possible reasons: 1. This sample of indigenous patients is integrated on Mental Health Services that offer a clear biomedical approach where drug therapy is the primary treatment. 2. It is possible that these indigenous patients are changing their conception of mental disorder, and 3. A significant number of families have migrated to urban areas. These migratory dynamics have promoted the loss of traditions and customs of the ethnic group, which gradually adopts new and intercultural lifestyles. Professionals should be warned about applying stereotypes regarding the relationship between ethnicity and antipsychotics.