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Factors influencing adherence to psychopharmacological medications in psychiatric patients: a structural equation modeling approach

Authors De las Cuevas C, de Leon J, Peñate W, Betancort M

Received 30 January 2017

Accepted for publication 28 February 2017

Published 28 March 2017 Volume 2017:11 Pages 681—690

DOI https://doi.org/10.2147/PPA.S133513

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Carlos De las Cuevas,1 Jose de Leon,2–4 Wenceslao Peñate,5 Moisés Betancort5

1Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, Canary Islands, Spain; 2Mental Health Research Center at Eastern State Hospital, Lexington, KY, USA; 3Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain; 4Biomedical Research Center in Mental Health Net (CIBERSAM), Santiago Apostol Hospital, University of the Basque Country, Vitoria, Spain; 5Departamento de Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna, Canary Islands, Spain

Purpose: To evaluate pathways through which sociodemographic, clinical, attitudinal, and perceived health control variables impact psychiatric patients’ adherence to psychopharmacological medications.
Method: A sample of 966 consecutive psychiatric outpatients was studied. The variables were sociodemographic (age, gender, and education), clinical (diagnoses, drug treatment, and treatment duration), attitudinal (attitudes toward psychopharmacological medication and preferences regarding participation in decision-making), perception of control over health (health locus of control, self-efficacy, and psychological reactance), and level of adherence to psychopharmacological medications. Structural equation modeling was applied to examine the nonstraightforward relationships and the interactive effects among the analyzed variables.
Results: Structural equation modeling demonstrated that psychiatric patients’ treatment adherence was associated: 1) negatively with cognitive psychological reactance (adherence decreased as cognitive psychological reactance increased), 2) positively with patients’ trust in their psychiatrists (doctors’ subscale), 3) negatively with patients’ belief that they are in control of their mental health and that their mental health depends on their own actions (internal subscale), and 4) positively (although weakly) with age. Self-efficacy indirectly influenced treatment adherence through internal health locus of control.
Conclusion: This study provides support for the hypothesis that perceived health control variables play a relevant role in psychiatric patients’ adherence to psychopharmacological medications. The findings highlight the importance of considering prospective studies of patients’ psychological reactance and health locus of control as they may be clinically relevant factors contributing to adherence to psychopharmacological medications.

Keywords: attitude to health, medication adherence, health behavior, internal-external control, model, statistical, psychiatry

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