Alcohol use in Tanzanians with chronic psychotic disorders and poor medication adherence

South African Journal of Psychiatry

Field Value
Title Alcohol use in Tanzanians with chronic psychotic disorders and poor medication adherence
Creator Simon, Emily Levin, Jennifer B. Mbwambo, Jessie Blixen, Carol Lema, Isaac Aebi, Michelle Njiro, Godwin Cassidy, Kristin Kaaya, Sylvia Sajatovic, Martha
Subject Psychiatry schizophrenia; medication adherence; treatment adherence; alcohol abuse; AUDIT; ASSIST; chronic psychotic disorders; sub-Saharan Africa; substance abuse
Description Background: The burden of chronic psychotic disorders (CPDs) in sub-Saharan Africa (SSA) is significant. Poorly medically adherent patients are more likely to have worse outcomes and require more resources. However, factors impacting effective treatment of CPD in this population are unclear.Aim: Examine the relationship between alcohol use and disease management and compare alcohol risk stratification between the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in poorly medication adherent Tanzanians with CPD.Setting: Muhimbili National Hospital and ambulatory clinics in Dar es Salaam, Tanzania.Methods: 100 Tanzanians with CPDs and suboptimal medication adherence were dichotomized into low and moderate-to-high risk alcohol use based on AUDIT scores and compared regarding medication attitudes, adherence and psychiatric symptoms. Patients completed the ASSIST for comparison to AUDIT risk stratification.Results: Moderate-to-high risk alcohol users had worse medication attitudes (p 0.01), medication adherence (previous week, p = 0.01; previous month, p 0.001), and psychiatric symptoms (p = 0.03). They were younger, predominately male and more likely to have a family history of alcohol abuse. A logistic regression analysis found age, gender and family history of abuse as significant predictors of hazardous alcohol use (p = 0.02, 0.02, 0.01, respectively). Risk stratification between AUDIT and ASSIST aligned in 85% of participants.Conclusion: Alcohol use is an important consideration in treating poorly adherent Tanzanians with CPD. The ASSIST was comparable to the AUDIT in stratifying risky alcohol use with the additional benefit of screening for other substances.
Publisher AOSIS
Contributor National Institute of Mental Health
Date 2021-03-19
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — survey
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajpsychiatry.v27i0.1570
Source South African Journal of Psychiatry; Vol 27 (2021); 10 pages 2078-6786 1608-9685
Language eng
Coverage Sub-Saharan Africa — Age 19 to 62; Male and female; Tanzanians with Chronic Psychotic Disorders
Rights Copyright (c) 2021 Emily Simon, Jennifer B. Levin, Jessie Mbwambo, Carol Blixen, Isaac Lema, Michelle Aebi, Godwin Njiro, Kristin Cassidy, Sylvia Kaaya, Martha Sajatovic