Medication Adherence and Quality of Life among Adults with Schizophrenia in Northwestern Nigeria: A Multicentre Cross-Sectional Study

Abstract

Background: Schizophrenia severely impacts quality of life (QoL), and medication adherence is crucial for managing symptoms and preventing relapse. However, adherence remains a significant challenge in resource-limited settings. Aims: This study aimed to evaluate the relationship between medication adherence and quality of life among adult patients with schizophrenia in North-Western Nigeria. Methods: A descriptive cross-sectional study was conducted involving 865 patients across seven states in North-Western Nigeria. Participants were selected using a multistage sampling technique. Adherence and QoL were assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and the WHOQOL-BREF, respectively. Data analysis included descriptive statistics, chi-square tests, and binary logistic regression (p < 0.05). Results: Findings revealed that 44.9% of participants had good adherence, 32.8% had moderate adherence, and 22.3% were poorly or non-adherent. Significant predictors of non-adherence included high medication costs (AOR = 4.25), adverse side effects (AOR = 3.14), poor drug accessibility (AOR = 2.94), polypharmacy (AOR = 2.71), and low educational attainment (AOR = 2.08). Good medication adherence was significantly associated with improved QoL across the physical, psychological, social, and environmental domains (p < 0.001). Conclusion: Medication adherence among these patients is suboptimal, primarily due to socio-economic and clinical barriers. Since adherence strongly predicts improved QoL, interventions should focus on affordable medication access, side-effect management, and psychoeducation.