Medication adherence in schizophrenia: Role of opinion makers

Background: Nonadherence to treatment is a recognized problem and the most challenging aspect of treatment, particularly in first-episode schizophrenia (FES). We aimed to identify a set of individuals in the social milieu of patients as opinion makers who play significant role in influencing treatment-seeking behavior in patients with FES. Materials and Methods: Patients with a diagnosis of schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), first episode, were administered with a 20 items semi-structured questionnaire to identify the individuals and their role in treatment-seeking behavior of patients with FES. Results: A total of 72 patients were enrolled in the study. The mean age of the sample was 29 years (standard deviation [SD] ±7.35), and the mean duration of illness was 9.2 (SD ± 0.58) months. Our study shows that apart from treating psychiatrists, patient's family members and relatives play a crucial role in influencing treatment-seeking behavior such as treatment commencement, drug dose, formulation, place of treatment, etc., A large number of patients went to faith healers on the advice of family members (34.7%) and also followed the advice of family members regarding the duration of treatment (63.3%) as well as discontinuing treatment (63.3%). Conclusion: The index study concludes the role of family members/relatives as opinion makers in the social milieu of patients with FES in influencing treatment-related decisions and affecting adherence to treatment.