Effectiveness of psychotherapy in improving medication adherence for hypertension and diabetes mellitus among displaced Myanmar patients in Thailand: A randomized control trial.

Displaced persons with non-communicable diseases (NCD) face challenges in disease management and increased risk of mental health problems. This randomized controlled trial assessed the impact of psychotherapy treatment (Common Elements Treatment Approach [CETA]) on hypertension and diabetes mellitus medication adherence (primary) and mental and physical health outcomes (secondary) among displaced Myanmar adults with poor medication adherence in a Thai shelter community. Treatment participants received weekly CETA for 4-12 weeks; comparison participants had access to routine psychosocial support. Eligible participants were chronic disease patients with <70% medication adherence over prior month. Data were collected at baseline, 3 and 6 months. Of 650 adults screened, 283 (43.5%) met eligibility criteria and 224 consented (CETA n = 112, comparison n = 112) to participate; 73 (32.6%) reported elevated mental health symptoms. At 6-month follow-up, medication adherence improved in both arms, with greater improvements among CETA participants (MARS-5: 0.55, 95% CI: 0.07 to 1.02, p = 0.023). CETA significantly reduced mental health symptoms among those with elevated symptoms at baseline (-3.06, 95% CI: -5.19 to -0.93, p = 0.005). The high rate of mental health symptoms and the impact of CETA on NCD medication adherence supports integration of mental health services into NCD care systems.