Clinical Pharmacy & Administration

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Subject: search.filters.subject.Non-adherence

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    Treatment Non-Adherence Among Patients With Poorly Controlled Type 2 Diabetes Am¬bulatory Care Settings In Southwestern Nigeria
    (2014) Adisa, R.; Fakeye, T . O
    Background: Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which un¬dermines the benefits of current medical care. Objectives: To evaluate the pattern of treatment non-adherence among ambulatory patients with poorly controlled type 2 diabetes in southwestern Nigeria, and to determine the possible factor(s) that accounted for such non-adherence with a view to identifying areas of future intervention to improve outcome. Methods: A prospective cross-sectional interview using the concept of RIM (Recognize, Identify and Manage) model was used to evaluate adherence to treatment recommendations among 176 consented patients recruited from the endocrinology out-patient clinics of two teaching hospitals in southwestern Nigeria between November, 2010 and January, 2011. Results: Overlaps of non-adherence behavior were obtained. More than three-quarter (153; 88.4%) were not aware of in¬dication for each of the prescribed medications, 26 (15.3%) correctly described regimen as prescribed. The factorsidentified as possible barriers to medication adherence include practical (145; 40.1%), knowledge (103; 28.5%), and attitudinal (114; 31.5%) barriers. Dietary non-adherence was mostly due to inappropriate guidance (62; 33.7%). Conclusions. The arrays of non-adherence behavior among the cohort further emphasize the need for patient-centered approach as a reasonable strategy in resolving non-adherence problems in routine clinical practice.
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    Associated With Hospitalisation of Hypertensive in-patients in a Tertiary Hospital, Southwestern Nigeria
    (2023-05) Ipingbemi, E . L; Erhun, W . O; Rasaq, A.
    The study aimed at estimating the cost of hospitalisation associated with medication non-adherence (MNA) among hypertensive in-patients in a tertiary healthcare facility in southwestern Nigeria. It involved a cross-sectional retrospective review of 322 medical records of hypertensive in-patients at the University College Hospital between 2013 and 2015. Physician’s documentation of MNA in the patients’ medical records prior to admission determined the eligibility into the study. Direct medical costs mainly consultation, medications, laboratory costs for individual patients during hospitalisation were calculated using out-of-pocket payer’s perspective approach. Data were summarised with descriptive statistics, Pearson’s product moment correlation coefficient was used to determine relationship between length of stay in hospital, cost of management and number of comorbidities at p < 0.05 considered statistically significant. Of the 322 medical records of hypertensive in-patients evaluated within the 3-year study period, 230 (71.4%) had a documentation of MNA. The average age was 55.9 ± 15.7 years old. Artisans/self-employed (n = 82; 35.7%) and petty traders (n = 61; 26.5%) made up the majority of the patients. The total cost of hospitalisation for the period studied was USD100,461.40 for all the patients, with an average of USD52.00 ± 28.10/patient/day, more than a quarter of which was spent on pharmaceuticals. Similarly, the costs of management also increased with increase in length of hospitalisation (Pearson’s product moment correlation r = 0.539, p = 0.000). The number of comorbid diseases increased the length of hospitalisation (r = 0.133, p = 0.044). Cost associated with hospitalisation in relation to MNA is high among the studied participants. There is a need to develop strategies to enhance medication adherence among patients with hypertension.