Adherence to therapy in sub-Saharan non-dialysed patients with chronic kidney diseases

作者：Seck Sidy Mohamed^*; Elhadj Fary Ka; Fall Seynabou; Cisse Mouhamadou Moustapha; Dia Daouda; Gueye Serigne; Pouye Abdoulaye; Niang Abdou; Diouf Boucar

来源：Nephrologie & Therapeutique, 2008, 4(5): 325-329.

DOI：10.1016/j.nephro.2008.02.004

• Adherence to therapy
• Chronic renal diseases
• Sub-Saharan Africa

Background. - Poor adherence to medication regimens accounts for substantial morbidity, mortality and increased health care costs in developing countries. The aim of this study is to assess adherence to therapy in patients with chronic kidney diseases and to identify the major barriers to adherence.
Patients and method. - A prospective study of non-dialysed patients with chronic kidney diseases followed during three months. Sociodemographic, clinical and therapeutic data were collected from medical records and patient interviews. Rate of adherence (ROA) was defined as the percentage of the prescribed doses of the medication actually taken by the patient over a four-week period. Statistical analysis was done with SPSS 11.0.
Results. - Mean age of the 118 included patients was 39.28 years +/- 16.4 (range 13-76 years); they were 56% female and one third had low instruction level. Socio-economic level was low for 38.5% of patients. Mean ROA was 81 +/- 12% (range 46 to 100%) but there was a difference between male (75%) and female (84%). Almost three quarters of patients (71%) had ROA more than 80%. Patients' adherence was inversely correlated to daily frequency of dose but not number of drugs. Major obstacles to adherence were complexity of drug regimen, forgetfulness, healthcare system inaccessibility, lack of information, side effects, automedication with phytotherapy and high cost of medications.
Conclusion.-Most of barriers to adherence can be overcome by improving communication between patients, health provider and healthcare system.

• 出版日期2008-10