Volume 28, Issue 3 (Autumn 2022)                   IJPCP 2022, 28(3): 322-335 | Back to browse issues page


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Arabi Khalilabad S, Khademoreza N, Homayooni A, Sorayya S, Effatnejat S, Kabir A, et al . Medication Adherence, Attitude Towards Medication, and Quality of Life in Outpatients With Neurotic Disorders in Tehran, Iran: A Six-Month Follow-up Study. IJPCP 2022; 28 (3) :322-335
URL: http://ijpcp.iums.ac.ir/article-1-3589-en.html
1- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2- Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
3- Research Center for Addiction & Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
4- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
6- Department of Psychiatry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
7- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran , drmrsh@gmail.com
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Introduction
Neurotic disorders have no psychotic symptoms and cover a wide range of psychiatric conditions. Due to lack of a suitable study to assess the attitudes towards medication, adherence to medication therapy, and quality of life (QoL) in patients with neurotic disorders in Iran, this study aims to evaluates these factors in adults with neurotic disorders referred to the psychiatric clinic of Tehran Psychiatric Institute.
Methods 
In this study, participants were adult outpatients who referred to the psychiatric clinic of Tehran Psychiatric Institute for the first time who were selected based on the inclusion criteria (age 18-60 years, having a neurotic disorder diagnosed by the psychiatrist, and consent to participate in the study). They were aassessed at the beginning of the study, and 1 and 6 months after their first visit to the clinic by using a demographic form, the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and the Drug Attitude Inventory (DAI-10). Their medication adherence was also assessed using the medication possession ratio.
Results
Of 100 participants, 76 were female and had a mean age of 35.9 years. In comparing the overall score of WHOQOL, a significant improvement was observed in the first and sixth months after the first visit compared to baseline (P<0.001) (Figure 1).

Regarding the domains of WHOQOL, mental health and general health status in the first and sixth months were significantly better compared to baseline (P<0.001). Physical health trend during the study was ascending. It was significantly better in the sixth month than in the first month. The trend of social relationships during the study was ascending. It was significantly better in the first month compared to the baseline. Environmental health trend during the study was also ascending. It was significantly better in the first month compared to the baseline.
The number of patients with favorable medication adherence increased from 37 in the first month to 63 in the sixth month. The paired t-test results for the raw DAI score at baseline and in the sixth month showed a significant increase (from 3.56±0.5 to 5.29±0.49) (P<0.001). Comparison of WHOQOL score among patients with favorable and unfavorable medication adherence in three time points showed no significant difference (P=0.6) (Figure 2).

Discussion 
The results of the present study, which evaluated the QoL, attitudes, and medication adherence of adult outpatients with neurotic disorders in Tehran, Iran, showed that in the sixth month after the first visit to the psychiatric clinic, QoL and its some domains as well as medication adherence and attitude towards medication were significantly improved in the outpatients. The physical and mental health domains were improved by medication therapy, but their social relationships and environmental health were less affected. There was no significant difference in QoL score between patients with favorable and unfavorable medication adherence. Based on the results of this study, it seems that medication therapy alone cannot improve all aspects of QoL in outpatients with neurotic disorders and their attitude towards medication; the use of psychosocial interventions along with medication therapy is recommended.

Ethical Considerations
Compliance with ethical guidelines

The current study was performed according to Helsinki Declaration and its revisions. All data gathered and analyzed anonymously after obtaining ethical approval from the Institutional Review Board of the Iran University of Medical Sciences (Code: IR.IUMS.FMD.REC.1398.121). The gathered data have been used only for research purposes and participants had been allowed to leave the study any time

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors contributions
Conception and planning: Somia Arabi Khalilabad, Shiva Soraya, Ali Kabir, Fatemeh Hadi and Mohammad Reza Shalbafan. Data collection: Samia Arabi Khalilabad, Sajjad Eftnejad and Mohammad Reza Shalbafan. Analysis and report of the results: Amirsina Homayoni, Ali Kabir and Mohammad Reza Shalbafan; The article was written by: Noushin Khadim al-Reza, Sajjad Efatnejad and Mohammad Reza Shalbafan. Review and final version: All authors.

Conflicts of interest
The authors have no conflicts of interest to report.


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Type of Study: Original Research | Subject: Psychiatry and Psychology
Received: 2021/10/8 | Accepted: 2022/01/4 | Published: 2022/12/22

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