Medication adherence among outpatients at the Jos University teaching hospital.
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Abstract
Background: For every 100 prescriptions written, 25 to 30 are taken properly. Non adherence to medication is a reality to be addressed by detecting the barriers in order to make interventions aimed at improving medication adherence among patients. The aim of this study is to assess the level of medication non adherence among outpatients at the Jos University Teaching Hospital in Nigeria and to identify the factors and barriers to medication adherence among the patients; alongside educating and counseling the patients in an effort to promote adherence.
Methods: A cross-sectional prospective study was carried out for 2 months from June 2013 to July 2013 at 6 outpatient departments of the Jos University Teaching Hospital in Plateau State, Northern Nigeria. Patients visiting the departments were involved in the study after taking their consent and completing a structured questionnaire. Statistical analysis was done using Microsoft Excel and Statistical Package for Social Sciences (SPSS) version 17.
Results: Out of 324 patients, 72 (22%) were non adherent to medication. The common cause of non-adherent behavior was forgetfulness (32%). Chi square test was conducted for categorical variables and adherence to medication was positively associated with psychiatry clinic recruits, male gender, higher educational level, absence of health insurance, fewer comorbidities, longer duration of condition and therapy, asking questions and satisfactory knowledge of medicines (p < 0.05). The result showed that 40% (25) of the 62 non adherent patients that needed interventions were educated and counseled on the need to link frequency of administration with routine activities so as to promote adherence.
Conclusion: This study reiterates the need for a systematic assessment of adherence to medication among patients alongside proffering adequate interventions to promote adherence to medication.
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References
Kravitz RL, Melnikow J. (2004) Medical adherence research: time for a change in direction. Medical Care.; 42: 197-199.
World Health Organization. (2003) Adherence to Long-term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization;. Available at: whqlibdoc.who.int/publication/2003/9241545992.pdf. Accessed May 16, 2013.
Wroth TH, Pathman DE. (2006) Primary medication adherence in a rural population: the role of the patient-physician relationship and satisfaction with care. Journal of the American Board of Family Medicine. 19(5):478-486.
Atreja A, Bellam N, Levy S. (2005) Strategies to enhance patient adherence: Making it simple. Medscape General Medicine. 7(1): 1-7.
Walid F G, Jerry G, Elizabeth A McGlynn. (2009). A Review of Barriers to Medication Adherence: A Framework for Driving Policy Options. RAND Corporation Available at: http://www.rand.org/content/dam/rand/pubs/technical_reports/2009/RAND_TR765.pdf. Accessed May 16, 2013.
National Association of Chain Drug Stores, (2010). Pharmacies: Improving Health, Reducing Costs, Based on IMS Health data. Available at:
www.maine.gov//legis/opta/healthreformpharmaciies.pdf
Akpa MR, Agomuoh DI, Odia OJ. (2005). Drug compliance among hypertensive patients in Port Harcourt Nigeria. Nigerian Journal of
Medicine. 14:55-57.
Amira CO, Okubadejo NU. (2007). Factors influencing non-compliance with antihypertensive drug therapy in Nigerians. Nigerian. Postgraduate Medical Journal.; 14(4):325-329.
Bello SI. (2012). Adherence and generic substitution among hypertensive patients in a specialist hospital. Global Advanced Research Journal of Medicine and Medical Sciences. 1(1):008-016.
Ikechukwu EO, Obinna UP, Ogochukwu AM. (2010). Predictors of Self-reported Adherence to Antihypertensive Medication in a Nigerian
Population. Journal of Basic and Clinical Pharmacy. 1(2): 133-138.
Eze UI, Ojieabu WA, Femi-Oyewo MN, Martins OO. (2011). Evaluation of Adherence in Elderly Diabetic Hypertensive Patients. International
Journal of Pharma Informa's Journal of Hospital and Clinical Pharmacy. 1: 38-45
Iloh GUP, Ofoedu JN, Njoku PU, Amadi AN, Godswill-Uko EU. (2013). Medication adherence and blood pressure control amongst
adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria. African Journal of Primary Health Care
& Family Medicine. 5(1):1-6.
Kabir M, Iliyasu Z, Abubakar IS, Jibril M. (2004). Compliance to medication among hypertensive patients in Murtala Mohammed Specialist
Hospital, Kano. Nigerian Journal of Community Medicine & Primary Health Care. 16(1): 16-20.
Ogboi SJ, Babajide F, Ademola OA, Olabunmi O, Agu PU. (2011). Evaluation of Factors Influencing Medication Adherence in Patients
with Epilepsy in Rural Communities of Kaduna State, Nigeria. Neuroscience & Medicine. 2:299-305.
Rasaq A, Martins BA, Titilayo OF. (2009). Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory
type 2 diabetes patients in Southwestern Nigeria. Pharmacy Practice (Internet). 7(3):163-169.
Rasaq A, Titilayo OF, Adesoji F. (2011).Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in Southwestern Nigeria. Pharmacy Practice (Internet). 9(2):72-81.
Roland NO, Cyprain KN. (2012). Assessment of patient's antihypertensive medication adherence level in non-comorbid hypertension in a tertiary hospital in Nigeria. International Journal of Pharmacy and Biomedical Sciences. 3(2): 47-54.
Cjeng TT , Bruce J, Debra JG, Alison RM, Emily JT. (2010). Barriers to Medication Adherence in Chronic Heart Failure Patients during Home
Visits. Journal of Pharmacy Practice and Research. 40(1):27 – 30.
Hichangeri SS , Neelkanthreddy P, Khavane K, Phanda S, Swarnakalama K. (2012). Assessment of medication adherence and factors affecting to medication adherence in asthma patients by clinical pharmacists. International Research Journal of Pharmacy. 3(3): 211-215.
Gabrielle KYL, Harry HXW, Kirin QLL, Yu C, Donald EM Martin CSW. (2013). Determinants of Medication Adherence to Antihypertensive
Medications among a Chinese Population Using Morisky Medication Adherence Scale. Public library ofscience One. 8:4.
Hyre AD, Krousel-Wood MA, Muntner P, Kawasaki L, DeSalvo KB. (2007). Prevalence and predictors of poor antihypertensive medication adherence in an urban health clinic setting. Journal of Clinical Hypertension. 9(3):179–186.
Wetzels GEC, Nelemans P, Schouten JS, Prins MH. (2004). Facts and fiction of poor compliance as a cause of inadequate blood pressure control: a systematic review. Journal of Hypertension. 22: 1849–1855.
Gerth WC. (2002). Compliance and persistence with newer antihypertensive agents. Current Hypertension Reports. 4: 424–433.
Billups SJ, Malone DC, Carter BL. (2000). The relationship between drug therapy noncompliance and patient characteristics, health-related quality of life, and health care costs. Pharmacotherapy. 20(8):941–949.
Pedan A, Varasteh L, Schneeweiss S. (2007). Analysis of factors associated with statin adherence in a hierarchical model considering physician, pharmacy, patient, and prescription characteristics. Journal of Managed Care & Specialty Pharmacy. 13(6):487–496.
Degli EE, Sturani A, Di MM, Falasca P, Novi MV, Balo G, Buda S, Volpe M. (2002).Long-term persistence with antihypertensive drugs in new
patients. Journal of Human Hypertension. 16: 439–444.
Carter BL. (2007). Adherence, Quality of Life, Cost Effectiveness, and the Role of the Pharmacist. In: Lip GYH, Hall JE, editors.
Comprehensive hypertension Philadelphia. Mosby Elsevier. 1119–1127.
Albright TL, Parchman M, Burge SK. (2001). Predictors of self-care behavior in adults with type 2 diabetes: an RRNeST study. Family Medicine. 33(5):354–360.
Bautista LE. (2008). Predictors of persistence with antihypertensive therapy: results from the NHANES. Americal Journal of Hypertension.
(2):183–188.
Janson SL, Earnest G, Wong KP, Blanc PD. (2008). Predictors of asthma medication nonadherence. Heart Lung. 37(3):211–218.
Kim EY, Han HR, Jeong S, Kim KB, Park H, Kang E, Shin HS, Kim MT. (2007). Does knowledge matter? Intentional medication nonadherence
among middle-aged Korean Americans with high blood pressure. Journal of Cardiovascular Nursing. 22(5):397–404.