Improving Medication Adherence among Patients with Schizophrenia in the Sunyani Municipality, Ghana: The Role of Therapeutic Alliance

Schizophrenia is a chronic condition associated with poor psychosocial and medical outcome. Non-adherence to anti-psychotic medications accounts for most of the relapses in schizophrenia, resulting in frequent hospital readmissions, self-harm, violence, and poor cognitive, clinical, and functional outcomes. This multicenter study examined the role of therapeutic alliance in medication adherence. The study was conducted at the Bono Regional Hospital and the Sunyani Municipal Hospital in Ghana. One hundred and eight (108) schizophrenia patients aged 18–60 years were recruited for the study through purposive sampling technique. The Medication Adherence Rating Scale (MARS) and the Scale to Assess the Therapeutic Relationship-Patients version (STAR P) were adapted for the study. Statistical Package for Social Sciences (SPSS) version 25 was used to analyze the data. Most of the respondents were between 18 and 35 years of age (85.2%). Males constituted 61.1% of the sample. A larger proportion of the respondents were residents of urban communities (66.7%). More than half of the sample did not have any formal education (51.9%) and 51.9% were unemployed. Mean (standard deviation) for medication adherence and therapeutic alliance were 4.56 (1.715) and 42.16 (7.710) respectively. Overall, therapeutic alliance was not associated with medication adherence; rs =.14, n = 108, p =.146. However, there was a weak negative correlation between affective bond and medication adherence; rs =.19, n = 108, p =.044. This finding highlights the need for clinicians to consistently seek patients’ views and concerns at each level of their treatment to achieve an optimum outcome.