Determinants of Antipsychotic Drug Accessibility and Their Impact on Treatment Adherence among Patients with Schizophrenia in North-Western Nigeria

Background: Schizophrenia requires prolonged use of anti-psychotics, yet accessibility challenges often hinder adherence in low-and middle-income nations. Purpose: This study examines factors influencing drug accessibility and their effect on treatment adherence in North-Western Nigeria. Methods: A cross-sectional survey was conducted among 865 individuals diagnosed with schizophrenia across seven states. Data was collected using a standardized questionnaire, including the Morisky Medication Adherence Scale (MMAS-8). Analysis employed SPSS, version 26 with descriptive statistics, Chi-square tests, and logistic regression, using a significance threshold of p < 0.05. Results: The mean age was 42.3 ± 11.2 years, and 53.9% were male. Adequate drug accessibility was reported by 53.7%, while 46.3% experienced poor accessibility due to high costs (75%), stock-outs (52.5%), and distance to facilities (53.1%). Adherence levels were classified as good (44.9%), moderate (32.8%), and poor (22.3%). Poor accessibility was significantly associated with low income (AOR=3.42), rural residence (AOR=2.18), and unemployment (AOR = 1.87). Predictors of non-adherence included structural barriers (high costs, frequent stock-outs, distance to facilities) and clinical factors (adverse effects, polypharmacy), as well as limited education. Patients with adequate accessibility were nearly three times more likely to adhere (AOR = 2.94, 95% CI=1.74-4.53). Conclusion: Drug accessibility strongly influences adherence to anti-psychotics among people with schizophrenia. Strengthening medicine supply chains, subsidizing costs, and expanding community-based support are vital for improved outcomes. Implications for Nursing: Nurses play a central role in improving adherence by addressing accessibility barriers, providing patient and family education, and advocating for affordable and consistent antipsychotic availability.