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The association between a free medicine program and functioning in people with schizophrenia: a cross-sectional study in Liuyang, China
- Source :
- PeerJ, PeerJ, Vol 8, p e8929 (2020)
- Publication Year :
- 2019
-
Abstract
- Background Persons with schizophrenia frequently discontinue or avoid medications. Under a national community-based mental health program many places in China have started to provide free medications to people with severe mental health disorders in their communities. In the free medication program (FMP) in Liuyang, China, peripatetic psychiatrists prescribed and dispensed antipsychotic medications free of charge at regular intervals and places convenient for all patients through the primary health care system since 2006. Our study aims to test whether adherence to this FMP improves the functioning of people with schizophrenia. Methods The research was conducted in Liuyang, a rural county in central China. Data were obtained from three sources: an ad-hoc survey and the program’s management system in 2013 and in-home interviews in 2014 in Liuyang. We conducted a cross-sectional propensity-score based analysis of the “dose” effect of FMP participation on their level of functioning, using medication refill adherence as a proxy for the participatory intensity in the program. Results Only 50.9% of 2,332 participants came for all refills in 2012. Higher refill adherence was associated with slightly worse functional outcomes. The main reasons for refill non-adherence were “unwilling to take medication or only took medication when unwell” (23.6%), “forgot or missed the appointment” (20.6%) and “hospitalized” (20.1%). Conclusions The FMP program in Liuyang seemed to have successfully removed barriers in cost and access. However, better refill adherence was not associated with better functional outcomes in this study, which might have been the result of reverse causation. To improve the effectiveness of the FMP, patient-centered measures should be considered.
- Subjects :
- medicine.medical_specialty
Mental health program
Cross-sectional study
lcsh:Medicine
Psychiatry and Psychology
General Biochemistry, Genetics and Molecular Biology
03 medical and health sciences
0302 clinical medicine
Medicine
Free medication program
030212 general & internal medicine
Association (psychology)
China
Psychiatry
Medication adherence
business.industry
General Neuroscience
lcsh:R
General Medicine
medicine.disease
Mental health
686 Program
Test (assessment)
Community-based mental health
Schizophrenia
Antipsychotic Medications
Public Health
General Agricultural and Biological Sciences
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 21678359
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- PeerJ
- Accession number :
- edsair.doi.dedup.....026548b9809fba9ffc102e120860d23a