Illness experience and reasons for nonadherence among individuals with XXXX who are poorly adherent with medication.

@entity1 @entity162 @entity734 @entity1887
AIM: Nonadherent individuals are the most likely to avoid participating in research studies, thus limiting potential opportunities to develop evidence-based approaches for adherence enhancement. This mixed-method analysis evaluated factors related to adherence among 20 poorly adherent community mental health clinic @entity1 with @entity162 ( @entity162 ). METHODS: Illness experience was evaluated with qualitative interview. Quantitative assessments measured symptoms (Hamilton Depression Rating Scale, Young Mania Rating Scale, Brief Psychiatric Rating Scale), adherence behavior, and treatment attitudes. Poor adherence was defined as missing 30% or more of medication. RESULTS: Minorities (80%), unmarried individuals (95%), and those with @entity734 (65%) predominated in this nonadherent group of @entity1 with @entity162 . Individuals were substantially depressed (mean Hamilton Depression Rating Scale, 19.2), had at least some @entity162 (mean Young Mania Rating Scale, 13.6), and had moderate psychopathology (mean Brief Psychiatric Rating Scale, 41.2). Rates of missed medications were 41% to 43%. Forgetting to take medications was the top reason for nonadherence (55%), followed by side effects (20%). Disorganized home environments (30%), concern regarding having to take long-term medications (25%) or fear of side effects (25%), and insufficient information regarding @entity162 (35%) were relatively common. Almost one third of @entity1 had individuals in their core social network who specifically advised against medication. Access problems included difficulty paying for medications among more than half of @entity1 . Interestingly, @entity1 reported good relationships with their providers. CONCLUSIONS: Forgetting to take medication and problems with side effects are primary drivers of nonadherence. Lack of medication routines, unsupportive social networks, @entity1887 , and treatment access problems may likewise affect overall adherence. Complementary quantitative and qualitative data collection can identify reasons for nonadherence and may inform specific clinical approaches to enhance adherence.
