{"doi":"10.1371/journal.pmen.0000236","title":"Socio-demographic and clinical predictors of medication adherence among psychiatric outpatients in Mozambique: A two-year longitudinal survival analysis","abstract":"Research on medication adherence among patients with psychiatric illness is particularly sparse in low- and middle-income countries (LMICs). This study examined the relationship between psychiatric medication adherence and clinical and sociodemographic factors in outpatient psychiatric settings in central Mozambique. We conducted a longitudinal study among 803 Psychiatric Outpatients (1,811 total follow-up visits) attending eight healthcare facilities in Mozambique from February 2022 to January 2024. Multivariable linear mixed and non-parametric Kaplan-Meier models were employed to analyze the association between medication and clinical/sociodemographic variables over time. Approximately 93% of patients (N = 729) were non-adherent to their medication at a minimum of one follow-up visit, with a median time in treatment prior to non-adherence of 60 days (mean: 52 days; 95% CI: 51, 53). In the Stratified Cox model, patients aged 56+ had a 33% higher hazard of nonadherence compared to those aged 18-35 (aHR: 1.33; 95% CI: 1.14, 1.55). Patients prescribed amitriptyline had a 56% higher hazard of nonadherence compared to those prescribed carbamazepine (aHR: 1.56; 95% CI: 1.23, 1.98). For every 30 days in treatment, disability scores decreased by an average of 0.13 (95% CI: -0.16 to -0.09) while systolic blood pressure decreased by 0.46 mmHg (95% CI: -0.18 to -0.10) and diastolic blood pressure decreased by 0.15 mmHg (95% CI: -0.23 to -0.06). Currently, the median duration of medication adherence for patients initiating essential psychiatric treatment in Mozambique is 60 days. Patients prescribed amitriptyline and older patients are at a higher risk of non-adherence. Consistent engagement in treatment is linked to lower disability scores and blood pressure. There is an urgent need for research into adherence support strategies, especially for these high-risk groups within Mozambique's mental health patient population.","journal":"PLOS mental health.","year":2025,"id":535990,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8952,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1420181,"name":"Morgan Turner","orcid":"0009-0001-9776-8651","position":1,"is_corresponding":false},{"id":466108,"name":"Alberto Muanido","orcid":"0000-0002-6602-7834","position":2,"is_corresponding":false},{"id":466107,"name":"Vasco Cumbe","orcid":"0000-0002-1131-8597","position":3,"is_corresponding":false},{"id":1420852,"name":"João Nhalimue Jala","orcid":null,"position":4,"is_corresponding":false},{"id":1420853,"name":"Ernesto Eusébio Armando","orcid":null,"position":5,"is_corresponding":false},{"id":933323,"name":"Flávia Faduque","orcid":null,"position":6,"is_corresponding":false},{"id":298926,"name":"Daniel A. Enquobahrie","orcid":"0000-0001-9844-0597","position":7,"is_corresponding":false},{"id":275587,"name":"Bradley H. Wagenaar","orcid":"0000-0002-3351-7175","position":8,"is_corresponding":false},{"id":1420180,"name":"Hiwot Weldemariam","orcid":"0009-0000-3435-2184","position":0,"is_corresponding":true}],"reference_count":17,"raw_metadata":null,"created_at":"2026-07-19T02:52:00.885532Z","pmid":"41661920","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}