Exploring facilitators for a transition from alternative and complementary therapies to evidence-based treatments in Ugandan first-episode psychosis patients

Introduction Most patients with psychotic disorders in Africa initially use alternative and complementary therapies leading to delays accessing evidence-based treatments. This delay, known as the duration of untreated psychosis (DUP), is associated with suboptimal response and reduced efficacy in short-term and long-term outcomes. In this study, we explore facilitators for transitioning from alternative and complementary therapies to evidence-based treatments for psychotic disorders, comparing these facilitators between patients and their caregivers. Methods The study was conducted at Butabika hospital in Kampala, Uganda. Participants included patients with first-episode psychosis who had used alternative and complementary therapies and their caregivers. An exploratory qualitative design using in-depth interviews was performed with thematic analysis used to analyze the data. Results We interviewed eight patients and eight caregivers. The key themes that led to a switch were the high cost of alternative therapies, a desire to know the cause of the illness, seeking better care and the influence of friends and community members. Themes were similar among the participants and their caregivers except for stigma, which was only found among the caregivers. Conclusions The reasons for transitioning from alternative and complementary therapies to evidence-based treatments are similar between patients and caregivers, except for stigma that is a more important factor for transition among caregivers. Since this was an exploratory study, additional research with a larger sample and more diverse population would enable a deeper understanding of these factors and guide the development of interventions to reduce DUP and improve outcomes for psychotic disorders.