BY ZIONE MAJAWA CHINOKO St. John of God College of Health Sciences, Mzuzu.

INTRODUCTION Antipsychotic adverse effects are the major reason for non- compliance to treatment. Antipsychotic adverse effects are undesirable, non-therapeutic and often predictable consequences of antipsychotic drugs (Fortinash & Worret, 2003:676). Knowledge of these helps clients manage the adverse effects. Not much information has been documented on clients’ knowledge, attitudes and practices in Africa and let alone in Malawi. Studies done in Western countries have shown that clients lack knowledge on the potential adverse effects and their management as a result most of them stop taking these medications.

AIM OF THE STUDY To assess the knowledge, attitudes and practices of clients on antipsychotic adverse effects at Bwaila psychiatric clinic in Lilongwe.

METHODOLOGY Quantitative study, cross-sectional descriptive design. Eighty (80) clients were sampled using systematic sampling. A self developed questionnaire was used to collect data. Ethical clearance, institutional authorization and consent for the study were sought from University of Malawi - KCN, the District Health Officer - Lilongwe district, and participants of the study respectively. SPSS was used to analyze data. Descriptive statistics were used to describe and analyze the selected variables.

RESULTS Sample description: All 80 clients who were sampled participated, giving a 100% response rate. The mean range was years. The majority of the study subjects were men, 63% (n=50) % (37) of the subjects were married, 37.5% (30) were single, 12.5% (10) were divorced and the remaining 3.75% (3) were widowed.

RESULTS Knowledge of antipsychotic adverse effects 58 out of 80 had never been informed about potential adverse effects (73%). 64 out of 80 had inadequate knowledge (80%). 65 out of 80 did not know how to manage the adverse effects (81%).

RESULTS Attitudes of clients towards antipsychotic adverse effects 53 out of 80 had negative attitudes (66%). 64 out of 80 indicated that they can recommend their friends and relatives to start antipsychotics if need arise (80%). Practices after experiencing adverse effects 61 out of 80 had good practices (76%). 52 out of 80 respondents indicated to have never stopped taking treatment despite experiencing the adverse effects (65%).

DISCUSSION The findings on knowledge were similar with most studies, nurses concern is to alleviate the psychotic symptoms forgetting that the drugs might cause discomforts which might lead to treatment non-compliance. On attitude, the findings are similar with most studies where the majority had negative attitudes. However on practices the findings differed with the study findings of Mitchel and Selmes (2007:4) where 82% reported missing doses or stopping treatment earlier than recommended because of the experienced adverse effects.

DISCUSSION Study limitations and implications Generalizability difficult as it only focused in Lilongwe (Bwaila). Study representation - subjects not equally represented (gender). Validity of the tool - self developed.

RECOMMENDATIONS Psycho-education on common antipsychotic adverse effects and other nursing strategies that promote awareness should be reviewed regularly. Nurses should plan their daily activities which must include issues of psycho-education, nurse managers must ensure that these are followed. Refresher courses on antipsychotic adverse effects and their management should be done regularly to all health service providers. Similar study should be done in all mental health institutions. Research should be done to assess knowledge of health care providers on antipsychotic adverse effects and their management.

ACKNOWLEDGEMENTS Mr. Michael Chisimba Nyirenda and Dr. I.W.A Musisi my supervisors.