The Polypharmacy Dilemma in Psychiatry: A Patient- Centered Mixed-Methods Exploration

Abstract Polypharmacy is a prevalent yet intricate practice in psychiatric treatment, gaining insight into patients' perspectives on polypharmacy is crucial for enhancing treatment adherence. Objective: This mixed-methods study investigated psychiatric patients' experiences and views on polypharmacy, combining quantitative data on its prevalence and attitudes with qualitative insights into personal experiences. Methods: Fifteen psychiatric patients were recruited from a single psychiatric facility. Quantitative data were gathered from 100 patients selected conveniently using the Drug Attitude Inventory (DAI-10) to evaluate their attitudes toward medication. Semi-structured interviews were conducted to delve into patients' personal experiences with polypharmacy. Thematic analysis was employed for qualitative data, while descriptive and inferential statistics were used for the quantitative aspect. Results: Quantitatively, 84% of participants were on polypharmacy regimens, with a moderately positive average DAI-10 score (M = 3.21, SD = 0.52). Patients on multiple medications exhibited more favorable attitudes than those on monotherapy. However, individuals with schizophrenia displayed significantly lower attitudes, possibly due to treatment fatigue. Qualitatively, themes emerged regarding understanding and involvement in medication planning, mixed attitudes toward polypharmacy, impact on daily life, side effects, adherence strategies, and patient-provider communication. Many participants expressed a wish for fewer medications, greater involvement in decision-making, and more structured support for adherence. Conclusion: The study underscores the complex and often conflicting attitudes psychiatric patients have toward polypharmacy. Incorporating patient perspectives into medication planning and improving communication can enhance adherence, trust, and therapeutic outcomes. These findings highlight the importance of personalized, collaborative care approaches in psychiatric medication management.