Factors Influencing Medication Adherence among Individuals with Schizophrenia: A Qualitative Meta-Synthesis Based on the Ecological Model

Purpose: This study aimed to synthesize qualitative research findings on factors influencing medication adherence in individuals with schizophrenia. Methods: This study used the qualitative meta-synthesis method proposed by Thomas and Harden to categorize results based on the ecological model. A systematic literature review of nine databases, including international (CINAHL, PubMed, and Web of Science) and domestic (DBpia, KCI, KISS, KoreaMed, RISS, and ScienceON) databases, was conducted from November 5 to December 4, 2024 to identify qualitative studies on medication adherence among South Korean adults aged 19 years or older who were diagnosed with schizophrenia. Results: Three studies on medication adherence in individuals with schizophrenia identified five key themes within the ecological model, encompassing both barriers and facilitators. These themes emerged across different factors, including intrapersonal (barriers: lack of insight and perceived burden of taking psychiatric medication; facilitators: acceptance of medication as treatment), interpersonal (facilitators: supportive systems), and community factors (barriers: stigma related to the use of psychiatric medication). Conclusion: These findings highlight the need for a comprehensive, multifactor approach to improving medication adherence in individuals with schizophrenia. This study also provides foundational data for the development of targeted interventions to enhance treatment adherence in these individuals.