Psychological intervention to enhance adherence to antipsychotic medication among patients with severe mental illnesses in Zambia: A Pilot Study

Abstract Background : Nonadherence to antipsychotic medication among service users living with severe mental illnesses (SULWSMI) contributes to high relapse rates, functional impairment, strained relationships with family and friends, suicide risk, and hospital readmissions. Psychological interventions, such as motivational interviewing (MI), have proven effective in enhancing medication adherence. Objectives: To assess feasibility, refine methods and identify potential barriers before implementing a full-scale study on psychological intervention to improve antipsychotic medication adherence among service users living with severe mental illnesses at Chainama Mental Hospital (CMH). Method: A total of twenty-five participants diagnosed with schizophrenia, severe depression, and bipolar I manic episodes were recruited from the psychiatric unit of Kabwe General Hospital. A purposive sampling technique was used to select study participants, utilising an attendance book, with the support of two psychiatric nurses on duty. The primary study comprises a population of 200 participants, while this pilot aimed to interview 10% of this figure, alongside an additional 5 participants, to account for potential refusals. Results : Twenty-one out of twenty-five participants were interviewed using an adapted Medication Adherence Rating Scale (MARS) questionnaire. Additionally, four out of twenty-one participants were randomly selected and consented to be interviewed using a self-developed interview guide. Four participants opted out, citing the need to attend to other matters. Conclusion : The intervention has shown feasibility and the potential to effectively improve adherence to antipsychotic medication. However, minor logistical adjustments are needed before launching a full-scale study.