Alcohol Use in Tanzanians with Chronic Psychotic Disorders and Poor Medication Adherence

Authors

Emily Simon, Case Western Reserve University
Jennifer B. Levin, Case Western Reserve UniversityFollow
Carol Blixen, Case Western Reserve UniversityFollow
Michelle Aebi, Case Western Reserve University
Kristin Cassidy, Case Western Reserve UniversityFollow
Martha Sajatovic, Case Western Reserve UniversityFollow

Author ORCID Identifier

Martha Sajatovic

Document Type

Article

Publication Date

3-19-2021

Abstract

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.

Keywords

schizophrenia, medication adherence, treatment adherence, alcohol abuse; AUDIT, ASSIST, chronic psychotic disorders, sub-Saharan Africa, substance abuse

Language

english

Publication Title

South African Journal of Psychiatry

Grant

R21MH1114700-01

Rights

© The Author(s) 2022. This is an Open Access work distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Simon E, Levin JB, Mbwambo J, Blixen C, Lema I, Aebi M, Njiro G, Cassidy K, Kaaya S, Sajatovic M. Alcohol use in Tanzanians with chronic psychotic disorders and poor medication adherence. S Afr J Psychiatr. 2021 Mar 19;27:1570. doi: 10.4102/sajpsychiatry.v27i0.1570. PMID: 33824753; PMCID: PMC8008015.