DETERMINANTS OF ADHERENCE TO LONG-TERM THERAPY FOR CHRONIC ILLNESSES AT SAINT PAUL’S MILLENIUM MEDICAL COLLEGE INTERNAL MEDICINE CHRONIC ILLNESS OUT PATIENT DEPARTMENT

Abstract

SUMMARY Background: Non-adherence to long term therapies in general practice has received increasing attention over the past few years. Its relationship to several determinant factors have been recognized. Non-adherence has serious clinical and economic consequences. The ability of patients to follow treatment plans in an optimal manner is frequently compromised by more than one barrier, usually related to different aspects of the problem. Patient characteristics independently associated with a higher odds of appointment non-adherence included not finishing high school, knowledge of disease the social and economic factors, the characteristics of the disease, disease therapies and patient-related factors. Objectives: to identify determinants and level of adherence to long term therapy for chronic illnesses at SPHMMC chronic illness clinic for diabetes and hypertension. Methods: Cross-sectional was used. Sample size was determined using the formula. The study population includes patients attending the chronic illness clinic for diabetes and hypertension. Data has been collected in the form an interview based on a structured interviewer provided questionnaire answered by eligible patients. There after data has been analyzed using the SPSS 20 software. Result: a total of 243 patients form the SPHMMC chronic illness OPD participated in the study. Results showed 164 (67.5%) were non adherent to the recommended long term therapy. It was also found that age, marital status, living situation, educational status were factors affecting the level of adherence. 213 (87.7%) patients reported to have missed two or less appointments, which shows high adherence to follow up. Conclusion and recommendation: The level of adherence to long term therapy at SPHMMC is alarmingly low (32.5%). Determinants of adherence included age, living situation, marital status and educational level. However, gender, type of chronic illness and occupation weren’t found to have significant effect on level of adherence. Based on these finding we recommend further research and studies be done on the factors affecting adherence to long-term therapy. As well as find ways to improve adherence.