Self-reported Medication Adherence in Schizophrenia and Bipolar Disorder Patients during COVID-19 Pandemic in a COVID Care Hospital: A Cross-sectional Study
VC01-VC05
Correspondence
Dr. Sajal Sathiadevan,
Assistant Professor, Department of Psychiatry, Government Medical College, Palakkad-678013, Kerala, India.
E-mail: sajalsathiadevan@gmail.com
Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has made it difficult for patients with Schizophrenia and Bipolar Affective Disorder (BPAD) to receive ongoing care, which has led to nonadherence to medication and undesirable health outcomes. Lower treatment adherence in severe mental illness might lead to symptom exacerbation and relapses and might cause a strain on the health system during the COVID-19 pandemic.
Aim: To assess treatment adherence in Schizophrenia and BPAD patients during the prevailing COVID-19 situation in India.
Materials and Methods: This cross-sectional study was conducted among 92 patients with Schizophrenia and BPAD through a questionnaire between January and September 2021 in a COVID-19 care hospital at Government Medical College Palakkad/District Hospital Palakkad, Kerala, India. Demographic and clinical data, adherence to treatment, along with Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D), Clinical Global impression (CGI S&I), Work and Social Adjustment Scale (WSAS), Modified COVID Threat Scale (CTS), and Medication Adherence Rating Scale (MARS) were collected. The outcomes included adherence to medication, deterioration of psychopathology, improvement in severity, and social functioning. Descriptive statistics were used to define the sample characteristics, presented as mean and standard deviation, and frequency and percentages. Spearman’s Correlation coefficient was used to find the correlation between MARS and other variables: CTS, BPRS, YMRS, HAM-D, CGI, and WSAS.
Results: A total of 92 patients were interviewed, which comprised 43 patients with Schizophrenia and 49 patients with Bipolar disorder. As assessed by the MARS rating scale, 19 patients (20.65%) had a MARS score less than six, suggesting poor adherence, and 73 (79.35%) had a MARS score of six or greater, suggesting better adherence to treatment. This was supported by negative correlation with BPRS, YMRS, HAM-D, and CGI-S and CGI-I scales, which implies that the COVID-19 pandemic did not hinder the patients from taking medication. The mean MARS score was 7.31±2.11. A total of 37 (40.2%) patients had acute exacerbation of the illness during the COVID-19 related lockdown, and 37 (40.2%) had exacerbation during the six months prior to the COVID-19 lockdown. There was a negative correlation between MARS scores and the CTS but was not statistically significant.
Conclusion: Despite the COVID-19 pandemic-related restrictions, patients with Schizophrenia and BPAD were adherent to medication, and the number of relapses during the COVID-19 pandemic was similar to the period before the pandemic. COVID-19-related anxiety did not have an impact on medication adherence and relapse in this study.