The medication management of patients with severe mental disorders has become an important task for primary medical institutions in China. However, there is currently a lack of a systematic review on the medication management of patients and the restrictive factors for their regular medication.

To systematically review the situation and influencing factors associated with medication management in Chinese patients with severe mental disorders, and to provide evidence-based evidence for optimizing patients' medication management.

CNKI, WanFang, VIP and PubMed Data were searched to collect cross-sectional studies on medication management in Chinese patients with severe mental disorders and discussing the influencing factors of regular medication. The search time limit was from the establishment of the database to August 2024. Two reviewers independently screened studies, extracted data and assessed the risk of bias of included studies. Meta-analysis was conducted on the management rate, standardized management rate, medication rate, and regular medication rate in the quantitative studies using Stata 17.0 software. At the same time, a qualitative summary analysis was conducted on the influencing factors of regular medication compliance among patients with severe mental disorders.

A total of fifty-nine studies were included, among which 41 studies quantitatively reported four indicators of patients' medication management. The results of meta-analysis indicated that the management rate of patients with severe mental disorders in China was 91.0% (95%CI=89.0%-93.0%), the standardized management rate was 77.0% (95%CI=70.0%-83.0%), and the medication rate was 72.00% (95%CI=66.0%-79.0%). The rate of regular medication was 50.0% (95%CI=44.0%-56.0%). From 2014 to 2021, the management rate, standardized management rate, medication rate and regular medication rate of patients increased from 73.7%, 35.8%, 35.0% and 17.9% to 96.7%, 94.1%, 87.0% and 84.2%, respectively. The management rate remained at a similar level in the eastern (92.3%), central (94.4%) and western (92.0%) regions. The standardized management rate, medication rate and regular medication rate were all higher in the eastern (86.5%, 82.5%, 62.7%), and central (81.2%, 88.1%, 57.9%) regions compared to the western (73.8%, 64.5%, 38.2%) region. Moreover, 18 studies qualitatively reported the influencing factors of regular medication in patients with severe mental disorders. The summary analysis showed that the restrictive factors affecting patients' regular medication was complex and diverse, mainly coming from five aspects: patients themselves, family caregivers, community management, hospital diagnosis and treatment, and government support.

The medication management ability of patients with severe mental disorders in China has significantly improved in recent years, but the differences among different regions are still considerable. In the future, based on multiple restrictive factors affecting patients' regular medication, collaborative management should be carried out to achieve the goal connotation of mental health management in China.