• Rutdakorn Nuntapanich Bencharak Hospital, Srisaket provice
  • Chawalin Inthong TaWai for Health Unit, Prince of Songkla University, Songkhla



schizophrenia, village health volunteers, medication adherence, beliefs about medication


This quasi-experimental study aimed to examine the effect of a village health volunteer training program on promoting medication adherence and specific beliefs about medication. Participants were schizophrenia patients at Bencharak Hospital, Srisaket Province with a history of medication non-adherence. The researchers purposively assigned conditions to two groups. The experimental group (14 participants) received home health care from trained village health volunteers and the control group (15 participants) received usual care. Medication adherence outcome was evaluated by the pill count method. Specific beliefs about medication were evaluated by questionnaires regarding necessary beliefs and concerns about medication at the baseline, 1 and 3 months of care. Independent t-test, Mann-Whitney U test and Generalized Estimating Equation (GEE) were used for data analysis. The results showed that there was no significant difference between the two groups at the baseline. Over three months of care and after the baseline was adjusted, the mean of medication adherence (9.09%; 95%CI: 5.00 – 13.18) and necessity belief about medication scores (1.52 scores out of 25; 95%CI: 0.72 – 2.33) in the experimental group were significantly higher than in the control group, respectively. Moreover, the concerns about medication score was significantly lower, 1.18 out of 25, (95%CI: -1.97 - -0.39) than the control group. Furthermore, at the end of the program, village health volunteers had significantly higher knowledge of caring for schizophrenia patients than before training (p=0.002). Therefore, the village health volunteer training program to promote medication adherence among schizophrenia patients in the community improved medication adherence, necessary belief about medication, decreased concern about medication and improved village health volunteers’ knowledge of caring for schizophrenia patients.


World Health Organization. Schizophrenia [Internet]. Geneva: World Health Organization ;2022[updated 2022 Jan 10; cited 2022 Jul 1]. Available from:

Department of Mental Health MoPH. Annual Report Department of Mental Health 2018. Bangkok; 2018. (in Thai)

Haddad PM, Brain C, Scott J. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies. Patient Relat Outcome Meas. 2014;5:43-62.

Ljungdalh PM. Non-adherence to pharmacological treatment in schizophrenia and schizophrenia spectrum disorders – An updated systematic literature review. Eur J Psychiat. 2017;31(4):172-86.

Gilmer TP, Dolder CR, Lacro JP, Folsom DP, Lindamer L, Garcia P, et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry. 2004;161(4):692–9.

Sendt K, Tracy D, Bhattacharyya S. A systematic review of factors influencing adhearence to antipsychotic medication in schizophrenia-spectrum disorder. Psychiatry Res. 2015;225(1-2):14-30.

Barkhof E, Meijer CJ, de Sonneville LM, Linszen DH, de Haan L. Interventions to improve adherence to antipsychotic medication in patienys with schizophrenia-A review of past decade. Eur Psychiatry. 2012;27(1):9-18.

Higashi K, Medic G, Littlewood KJ, Diez T, Granström O, De Hert M. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review. Ther Adv Psychopharmacol. 2013;3(4):200–18.

Thanabodee-tummajaree P, Themrasi B. The development of the program to promote illness awareness and belife in taking medications on medication adherance in patients with schizophrenia. JPNMH. 2018;32(3):133-53. (in Thai)

Huaisai J, Suriyakri S. Factor associated with medicatiion adherence in schizophrenic patients at Dong Luang Hospital. Srinagarind Med J. 2019(2):150-4. (in Thai)

Jaroenphol P, Sangon S, Nintachan P. Selected factors related to medication adherence in persons with schizophrenia. JPNMH. 2017;33(2):29-46. (in Thai)

Sangpak C, P T, Kitsumban V. Effect of the adherence therapy on medication adherence among persons with schizophrenia in community. Nurs J. 2020;44(1):137-48. (in Thai)

Puedkuntod P. Development of schizophrenia patients care model in the health services network of Lahansai District Buriram Province. J Med & Public Health, UBU. 2019;2(2):95-107. (in Thai)

Pagaiya N, Khaonuan B, Phanthunane P, Bamrung A, Jirawattanapisal T. Human Resources for Health Projections for Primary Health Care Services in Thailand 2026.JHSR .2018;12(2):189-204 (in Thai)

Tangmanokun A, Surasak Chaiyasong S. Cost-Effectiveness of Home Health Care vs Usual Care in Patients with Schizophrenia by Multidisciplinary Team of Donmoddaeng District Health Service Network in Ubonratchathani. Thai J Pharm Prac. 2022;14(3):523-540. (in Thai)

Ontha R, Moolsart S, Pitchayapinyo P. The development of a home visit model based on participation between professional nurses and village health volunteers for Type II Diabetes. J Nurs Health Care. 2016;4:19-27. (in Thai)

Manadee C, Ploylearmsang C, Sookaneknun P. Effects of elderly care with chronic diseases on quality use of medicine at home in area of sub-district health promoting hospitals Somdet District Kalasin Province. Isan J Pharm Sci. 2014;10(3):354-71. (in Thai)

Tangmanokun A, Chaiyasong S. Outcomes of home health care in patients with schizophrenia by multidisciplinary team of Donmoddaeng district health service network in Ubonratchathani. JHSR.2021;15(4):436-55. (in Thai)

Yapong P, Lerkiatbundit S, Saengcharoen W. Effects of interventions by pharmacists in caregivers to improve medication adherence and clinical outcomes in patients with schizophrenia by “Patient-Tailoring Strategies”. Thai J Pharm Prac. 2561;10(2):591-606. (in Thai)

Service project for chronic psychiatric patients in the community NHSF. Community care guide in chronic psychiatric patients for primary care Nonthaburi: National Health Security Office; 2016. (in Thai)

Worasuwat N. Manual for village health volunteers specializing in mental health. Khonkhan: Mental Health Center 7, Department of Mental Health, Ministry of Public Health; 2015. (in Thai)

Department of Mental Health MoPH. Schizophrenia Care Manual for hospitals in Public Heath Regions. Nonthaburi: Department of Mental Health, Ministry of Public Health; 2017. (in Thai)

Leaungsomnapa Y, Promproh S, Leaungsomnapa S, Sourthao Y. Influence of beliefs about medication on high group of medication adherence in hypertensive patients. JPMC. 2013;30(2):146-57. (in Thai)

Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework. PLOS ONE. 2013;8(12):1-24.

Chankham W. The development of psychiatric and mental healthcare system in the community: roles of psychiatric nurses. JPNMH. 2016;30(3):1-9. (in Thai)

Khaektao P, Wongpanom S, Tippinij J, Noppamit H. The effect of skills development program for healthcare volunteers on providing care for psychiatric patients and their families. JPNMH. 2011;25(2):130-42. (in Thai)

Prasurat J, Pansila W, Promasatayaprot V. Community participation model for preventing recurrent symptoms of schizophrenic patients in Nongkhu community Senangkhanikhom District, Amnat Charoen Province. AJCPH. 2020;6(4):184-98. (in Thai)






Original Research Articles