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Inicio Revista Colombiana de Psiquiatría (English Edition) Adherence to psychopharmacological treatment in patients with severe and persist...
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Vol. 53. Issue 2.
Pages 192-205 (April - June 2024)
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Vol. 53. Issue 2.
Pages 192-205 (April - June 2024)
Review Article
Adherence to psychopharmacological treatment in patients with severe and persistent mental disorders: A systematic review
Adherencia al Tratamiento Psicofarmacológico de los Pacientes con Trastornos Mentales Graves y Persistentes: Revisión Sistemática
María José Alvear Velásquez
Corresponding author
majoalvear0@gmail.com

Corresponding author.
, Iván Patricio Sandoval Carrión
Departamento de Psiquiatría, Universidad Central del Ecuador, Quito, Ecuador
Article information
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Figures (1)
Tables (4)
Table 1. Analysis of the articles selected.
Table 2. Year of publication and design of the assessed studies.
Table 3. Study population.
Table 4. Degree of adherence and incidence of medication non-adherence.
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Abstract
Introduction

It is known that non-adherence to psychiatric medications has harmful consequences for both patients and society.

Objective

To collect information on the incidence of non-adherence, and the factors and causes affecting adherence to psychopharmacological treatment in patients with severe and persistent mental disorders.

Methods

A systematic review of scientific articles on adult patients (>17 years) published in the last five years (2015–2020) on specialised databases such as PubMed, Scopus, Scielo and BioMed. Original articles from indexed journals with an impact factor >0.5, in English or Spanish, with an analytical, prospective, retrospective, cross-sectional and randomised design were included. Once the articles were identified, they were analysed, extracting the information necessary to answer the research questions.

Results

Fifteen articles were included. Of these, 40% (n = 6) were published in 2020, 20% (n = 3) were produced in China and 53.3% (n = 8) had an observational design. A total of 5,837 patients were included, of which 50.6% were men (n = 2,955), with moderate adherence (n = 10; 66.7%) reported in 10 investigations. Non-adherence varies from 7.7% to 60.6%. The factors that affect adherence are specific to the patient (age and sex), their family support network, and related to the disease or the treatment. The main cause of non-adherence is lack of insight.

Conclusions

Adherence to treatment with psychotropic drugs is multifactorial. Access to mental health services should be improved, with an emphasis placed on patient education and providing greater knowledge of mental illness. Interventions to promote education and interaction with the psychiatrist could be beneficial.

Keywords:
Medication adherence
Psychotropics
Schizophrenia
Bipolar disorder
Depression
Severe mental illness
Resumen
Introducción

Se sabe que la falta de adherencia a los medicamentos psiquiátricos tiene consecuencias perjudiciales tanto para los pacientes como para la sociedad.

Objetivo

Recopilar información sobre la incidencia de falta de adherencia, los factores y las causas que afectan a la adherencia al tratamiento psicofarmacológico de los pacientes con trastornos mentales graves y persistentes.

Métodos

Revisión sistemática de artículos científicos en pacientes adultos (edad > 17 años), publicados en los últimos 5 años (2015-2020) en bases de datos especializadas como PubMed, Scopus, Scielo y BioMed. Se incluyeron artículos de revistas indexadas con factor de impacto > 0,5 en inglés o español, originales, con diseño analítico, prospectivo, retrospectivo, transversal y aleatorizados. Una vez identificados los artículos, se procedió a su análisis, extrayendo la información necesaria para responder las preguntas de investigación.

Resultados

Se incluyeron 15 artículos, el 40% (n = 6) publicados en 2020, el 20% (n = 3) realizados en China y el 53,3% (n = 8) de diseño observacional. Se incluyó una población total de 5.837 pacientes, varones el 50,6% (n = 2.955). Reportaron adherencia moderada 10 investigaciones (66,7%). La falta de adherencia varía desde el 7,7 al 60,6%. Los factores que afectan a la adherencia son propios del paciente (edad y sexo) o su red de apoyo familiar, relacionados con la enfermedad o el tratamiento. La principal causa de la falta de adherencia es la ausencia de insight.

Conclusiones

La adherencia al tratamiento con psicofármacos es multifactorial. Se debería mejorar el acceso a los servicios de salud mental, poner énfasis en la formación del paciente y aportar mayor conocimiento de la enfermedad mental; la formación y la interacción con el psiquiatra podrían ser intervenciones beneficiosas.

Palabras clave:
Adherencia
Psicotrópicos
Esquizofrenia
Trastorno bipolar
Depresión
Trastorno mental grave

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