Medication adherence and needs among patients with schizophrenia in China: a qualitative study

Objectives To explore the factors influencing medication adherence and the medication needs of patients with schizophrenia when living in a community in China. Design A qualitative study. Setting Community and psychiatric ward in Zhuhai city, Guangdong province. Participants Patients with schizophrenia and (or) their primary caregivers. Primary and secondary outcome measures Facilitators and barriers of medication adherence and the medication needs. Results A total of 20 patients with schizophrenia and 12 primary caregivers participated in the study. Based on the Health Ecology Model, the analysis identified four levels of factors influencing medication adherence, categorised as individual (facilitators: effective treatment, positive expectation, establishing a routine and assistive tools; barriers: side effects, inadequate knowledge, forgetfulness and irregular daily schedule), interpersonal (facilitators: caregiver assistance and psychiatrist's recommendation; barriers: lack of social support), community (facilitators: community mental health services and reducing medication use frequency; barriers: limited medication accessibility and affordability) and policy and culture related (facilitators: collectivist culture and social security policy; barriers: stigma). Additionally, five medication needs (managing side effects, applying for social security, improving medication accessibility, transitioning to long-acting injections and getting health education) were recognised. Conclusions These findings offer valuable insights for healthcare providers and policymakers, underscoring the need for targeted interventions to enhance medication adherence among patients with schizophrenia in China.