BACKGROUND Major psychiatric disorders are growing public health concern that attributed 14% of the global burden of diseases. The management of major psychiatric disorders is challenging mainly due to medication non-adherence. However, there is a paucity of summarized evidence on the prevalence of psychotropic medication non-adherence and associated factors. Therefore, we aimed to summarize existing primary studies' finding to determine the pooled prevalence and factors associated with psychotropic medication non-adherence. METHODS A total of 4504 studies written in English until December 31, 2017, were searched from the main databases (n = 3125) (PubMed (MEDLINE), Embase, CINAHL, PsycINFO, and Web of Science) and other relevant sources (mainly from Google Scholar, n = 1379). Study selection, screening, and data extraction were carried out independently by two authors. Observational studies that had been conducted among adult patients (18 years and older) with major psychiatric disorders were eligible for the selection process. Critical appraisal of the included studies was carried out using the Newcastle Ottawa Scale. Systematic synthesis of the studies was carried out to summarize factors associated with psychotropic medication non-adherence. Meta-analysis was carried using Stata 14. Random effects model was used to compute the pooled prevalence, and sub-group analysis at 95% confidence interval. RESULTS Forty-six studies were included in the systematic review. Of these, 35 studies (schizophrenia (n = 9), depressive (n = 16), and bipolar (n = 10) disorders) were included in the meta-analysis. Overall, 49% of major psychiatric disorder patients were non-adherent to their psychotropic medication. Of these, psychotropic medication non-adherence for schizophrenia, major depressive disorders, and bipolar disorders were 56%, 50%, and 44%, respectively. Individual patient's behaviors, lack of social support, clinical or treatment and illness-related, and health system factors influenced psychotropic medication non-adherence. CONCLUSION Psychotropic medication non-adherence was high. It was influenced by various factors operating at different levels. Therefore, comprehensive intervention strategies should be designed to address factors associated with psychotropic medication non-adherence. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017067436.

中文翻译：

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重大精神疾病患者中精神药物的非依从性及其相关因素：系统评价和荟萃分析。

背景技术主要的精神疾病正引起越来越多的公共卫生关注，该疾病占全球疾病负担的14％。主要的精神疾病的治疗具有挑战性，这主要是由于药物的不依从性。然而，关于精神药物非依从性的流行和相关因素的总结证据很少。因此，我们旨在总结现有的主要研究结果，以确定合并的患病率和与非药物治疗相关的因素。方法截至2017年12月31日，从主要数据库（n = 3125）（PubMed（MEDLINE），Embase，CINAHL，PsycINFO和Web of Science）和其他相关来源（主要来自Google Scholar，n = 1379）。研究选择，筛选，和数据提取是由两位作者独立进行的。在患有严重精神疾病的成年患者（18岁及以上）中进行的观察性研究符合选择的条件。使用Newcastle Ottawa量表对纳入的研究进行了严格的评估。对研究进行了系统综合，总结了与精神药物不依从相关的因素。使用Stata 14进行Meta分析。使用随机效应模型计算合并患病率，并以95％置信区间进行亚组分析。结果系统评价包括46项研究。其中，荟萃分析包括35项研究（精神分裂症（n = 9），抑郁症（n = 16）和双相情感障碍（n = 10））。总体，49％的严重精神病患者不遵循精神药物治疗。其中，精神分裂症，重度抑郁症和双相情感障碍的精神药物非依从性分别为56％，50％和44％。个别患者的行为，缺乏社会支持，临床或治疗以及与疾病相关的因素以及卫生系统因素影响了精神药物的不依从性。结论精神药物的不依从性很高。它受到不同级别运作的各种因素的影响。因此，应设计综合干预策略以解决与精神药物不依从相关的因素。系统审查注册PROSPERO CRD42017067436。精神分裂症，重度抑郁症和双相情感障碍的非精神科药物治疗分别为56％，50％和44％。个别患者的行为，缺乏社会支持，临床或治疗以及与疾病相关的因素以及卫生系统因素影响了精神药物的不依从性。结论精神药物的不依从性很高。它受到不同级别运作的各种因素的影响。因此，应设计综合干预策略以解决与精神药物不依从相关的因素。系统审查注册PROSPERO CRD42017067436。精神分裂症，重度抑郁症和双相情感障碍的精神药物非依从性分别为56％，50％和44％。个别患者的行为，缺乏社会支持，临床或治疗以及与疾病相关的因素以及卫生系统因素影响了精神药物的不依从性。结论精神药物的不依从性很高。它受到不同级别运作的各种因素的影响。因此，应设计综合干预策略以解决与精神药物不依从相关的因素。系统审查注册PROSPERO CRD42017067436。和卫生系统因素影响了精神药物的不依从性。结论精神药物的不依从性很高。它受到不同级别运作的各种因素的影响。因此，应设计综合干预策略以解决与精神药物不依从相关的因素。系统审查注册PROSPERO CRD42017067436。和卫生系统因素影响了精神药物的不依从性。结论精神药物的不依从性很高。它受到不同级别运作的各种因素的影响。因此，应设计综合干预策略以解决与精神药物不依从相关的因素。系统审查注册PROSPERO CRD42017067436。