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Factors Associated with Medication Adherence Among Patients with Severe Mental Disorders in China: A Propensity Score Matching Study

Authors Dou L, Hu L, Zhang N, Cutler H, Wang Y, Li S

Received 28 March 2020

Accepted for publication 26 June 2020

Published 31 July 2020 Volume 2020:14 Pages 1329—1339

DOI https://doi.org/10.2147/PPA.S255934

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Naifeng Liu


Lei Dou,1,2 Lili Hu,3 Nan Zhang,1,2,4 Henry Cutler,5 Yan Wang,6 Shunping Li1,2

1School of Health Care Management, Shandong University, Jinan 250012, People’s Republic of China; 2NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, People’s Republic of China; 3Shandong Mental Health Center, Jinan, 250000, People’s Republic of China; 4Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, People’s Republic of China; 5Centre for the Health Economy Macquarie University, Sydney, 2109, Australia; 6Health Commission of Shandong Province, Jinan 250014, People’s Republic of China

Correspondence: Shunping Li
School of Health Care Management, Shandong University, Wenhua Xi Road 44, Jinan, Shandong Province 250012, People’s Republic of China
Tel +86-131-8893-4998
Email lishunping@sdu.edu.cn

Objective: The 686 project provides free essential drugs and follow-up for poor SMD patients, with the purpose of improving patients’ medication adherence and reducing the occurrence of dangerous behaviors. The objective of this research was to determine the factors that influence medication adherence in patients with severe mental disorders (SMD) and analyze whether the 686 program significantly improved patient medication adherence.
Methods: This study was conducted among SMD patients in 686 project and non-project SMD patients in the same community in 11 cities in Shandong Province of China. The data collected included basic patient information and disease treatment information. Medication adherence was divided into good adherence and poor adherence. Propensity score matching (1:1 match) was performed to adjust for differences in baseline characteristics.
Results: One thousand two hundred ninety-two patients receiving free medication assistance policy (686 project group) and 1292 non-policy patients (control group) were analyzed. Patients who received the 686 project group had significantly better medication adherence than the non-policy group patients (92.6% vs.61.2%). Older age and consolidation period were associated with poor adherence, and education level was the positive determinant for adherence.
Conclusion: The 686 project could improve medication adherence to patients with SMD. Additional research will pay attention to medication adherence of patients who are elderly, in consolidation period and lower education levels. It should strengthen the guidance and supervision of patients’ medication and strengthen the health education of family members and patients.

Keywords: medication adherence, severe mental disorders, propensity score matching

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