Adherence in Egyptian patients with schizophrenia: the role of insight, Medication beliefs and spirituality

Objective: Reports about medication adherence in Arab patients with schizophrenia and the possible confounding factors are lacking. The aim of the present study was to determine whether insight, spirituality and patient beliefs about the necessity and concerns about medication were associated with adherence among those presenting with schizophrenia in an outpatient facility. Methods: At the end of a routine follow up with their psychiatrist, patients completed questionnaires, including the Schedule for the Assessment of Insight (SAI-E), Morisky Medication Adherence Scale (MMAS), Arabic Daily Spiritual Experience Scale (DSES) and Beliefs about Medicines Questionnaire (BMQ). Results: A sample of 92 patients with schizophrenia was studied. On the basis of the MMAS results, 24 (26%) patients were categorized as medication adherent and 68 (74%) as medication non-adherent. Logistic regression analysis showed that the SAI and DSES sores were positive predictors of adherence whereas the BMQ concern subscale score was a negative predictor of adherence. Conclusions: The present study extended prior research in western cultures on the role of insight, patient beliefs and spirituality in medication adherence in a sample of Arab patients with schizophrenia. Further examination of the influence of spirituality on adherence is required to explicate this relationship.