Psychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis study
Abstract Background Over half of patients take medications incorrectly, with non-adherence being a significant challenge in managing mental illnesses and to healthcare systems globally. In mental health, non-adherence to psychotropic medications exacerbates symptoms, increases relapse rates, and con...
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2025-04-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22408-w |
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| author | Gebresilassie Tadesse Gebremariam Wulie Geremew Tekletsadik Tekleslassie Alemayehu Demis Getachew Digafe Demelash Setegn Fentahun |
| author_facet | Gebresilassie Tadesse Gebremariam Wulie Geremew Tekletsadik Tekleslassie Alemayehu Demis Getachew Digafe Demelash Setegn Fentahun |
| author_sort | Gebresilassie Tadesse |
| collection | DOAJ |
| description | Abstract Background Over half of patients take medications incorrectly, with non-adherence being a significant challenge in managing mental illnesses and to healthcare systems globally. In mental health, non-adherence to psychotropic medications exacerbates symptoms, increases relapse rates, and contributes to treatment resistance, higher hospitalization rates, and mortality. It also places a financial burden on healthcare systems through preventable hospitalizations and prolonged treatments. Understanding the prevalence and determinants of non-adherence is particularly critical in low-resource settings like Ethiopia, where mental health services are underfunded and sociocultural factors influence treatment behaviors. Therefore, this study aimed to estimate the pooled prevalence and determinants of psychotropic medication non-adherence in Ethiopia. Methods Primary articles were sourced from PubMed (Medline), EMBASE, CINAHL, Web of Science, PsycINFO, Google, and Google Scholar. The review included studies reporting the prevalence and determinants of psychotropic medication non-adherence among individuals with mental illness. Data were extracted using Microsoft Excel and analyzed in STATA 14. A random effects model was applied to estimate the pooled prevalence, and subgroup analyses were performed to explore heterogeneity. Publication bias was assessed using Egger’s test and a funnel plot. Results Seventeen studies with 7,097 participants were included. The pooled prevalence of psychotropic medication non-adherence was 43.98% (38.15, 49.81). Subgroup analysis revealed regional variations with prevalence rates of 52.85% in Harari, 52.4% in Amhara, 46.39% in Oromia, 39.8% in Addis Ababa, and 27.42% in Tigray. Significant determinants included negative attitudes toward treatment (OR: 3.69; 95% CI: 2.73–4.99), lack of insight (OR: 3.20; 95% CI: 1.71–5.99), medication side effects (OR: 2.84; 95% CI: 2.05–3.93), perceived stigma (OR: 2.41; 95% CI: 1.87–3.10), substance use (OR: 2.36; 95% CI: 2.02–2.74), and poor social support (OR: 2.30; 95% CI: 1.61–3.29). Conclusions and recommendations This study found that over four in ten people with mental illness were non-adherent to medications. It is recommended to design intervention strategies that address the factors associated with non-adherence to psychotropic medication. Prospero registration CRD42024563343. |
| format | Article |
| id | doaj-art-e805df87fe4c46ae9e6bc532d83e1a83 |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| spelling | doaj-art-e805df87fe4c46ae9e6bc532d83e1a832025-08-20T03:06:55ZengBMCBMC Public Health1471-24582025-04-0125111610.1186/s12889-025-22408-wPsychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis studyGebresilassie Tadesse0Gebremariam Wulie Geremew1Tekletsadik Tekleslassie Alemayehu2Demis Getachew3Digafe Demelash4Setegn Fentahun5Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of GondarDepartment of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of GondarDepartment of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of GondarDepartment of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of GondarAbstract Background Over half of patients take medications incorrectly, with non-adherence being a significant challenge in managing mental illnesses and to healthcare systems globally. In mental health, non-adherence to psychotropic medications exacerbates symptoms, increases relapse rates, and contributes to treatment resistance, higher hospitalization rates, and mortality. It also places a financial burden on healthcare systems through preventable hospitalizations and prolonged treatments. Understanding the prevalence and determinants of non-adherence is particularly critical in low-resource settings like Ethiopia, where mental health services are underfunded and sociocultural factors influence treatment behaviors. Therefore, this study aimed to estimate the pooled prevalence and determinants of psychotropic medication non-adherence in Ethiopia. Methods Primary articles were sourced from PubMed (Medline), EMBASE, CINAHL, Web of Science, PsycINFO, Google, and Google Scholar. The review included studies reporting the prevalence and determinants of psychotropic medication non-adherence among individuals with mental illness. Data were extracted using Microsoft Excel and analyzed in STATA 14. A random effects model was applied to estimate the pooled prevalence, and subgroup analyses were performed to explore heterogeneity. Publication bias was assessed using Egger’s test and a funnel plot. Results Seventeen studies with 7,097 participants were included. The pooled prevalence of psychotropic medication non-adherence was 43.98% (38.15, 49.81). Subgroup analysis revealed regional variations with prevalence rates of 52.85% in Harari, 52.4% in Amhara, 46.39% in Oromia, 39.8% in Addis Ababa, and 27.42% in Tigray. Significant determinants included negative attitudes toward treatment (OR: 3.69; 95% CI: 2.73–4.99), lack of insight (OR: 3.20; 95% CI: 1.71–5.99), medication side effects (OR: 2.84; 95% CI: 2.05–3.93), perceived stigma (OR: 2.41; 95% CI: 1.87–3.10), substance use (OR: 2.36; 95% CI: 2.02–2.74), and poor social support (OR: 2.30; 95% CI: 1.61–3.29). Conclusions and recommendations This study found that over four in ten people with mental illness were non-adherent to medications. It is recommended to design intervention strategies that address the factors associated with non-adherence to psychotropic medication. Prospero registration CRD42024563343.https://doi.org/10.1186/s12889-025-22408-wPsychotropic medicationNon-adherenceMental illnessSystematic review and meta-analysisEthiopia |
| spellingShingle | Gebresilassie Tadesse Gebremariam Wulie Geremew Tekletsadik Tekleslassie Alemayehu Demis Getachew Digafe Demelash Setegn Fentahun Psychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis study BMC Public Health Psychotropic medication Non-adherence Mental illness Systematic review and meta-analysis Ethiopia |
| title | Psychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis study |
| title_full | Psychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis study |
| title_fullStr | Psychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis study |
| title_full_unstemmed | Psychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis study |
| title_short | Psychotropic medication non-adherence and its determinants among people living with mental illnesses in Ethiopia: systematic review and meta-analysis study |
| title_sort | psychotropic medication non adherence and its determinants among people living with mental illnesses in ethiopia systematic review and meta analysis study |
| topic | Psychotropic medication Non-adherence Mental illness Systematic review and meta-analysis Ethiopia |
| url | https://doi.org/10.1186/s12889-025-22408-w |
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