Investigation of the medication adherence behaviour of private sector patients with communicable and non-communicable diseases.

Masters Degree. University of KwaZulu-Natal, Durban.Background: Medication adherence continues to be a vital factor contributing towards the achievement of treatment goals in patients with chronic diseases. There is a sparse amount of data available on the adherence behaviour and the types of medications used in private sector patients with communicable and non-communicable diseases in South Africa but this is limited and dated. This study was directed at providing information on the medication adherence rates of such patients and the factors that influence such behaviour. Aim and Objectives: To investigate the medication adherence behaviour of patients suffering from noncommunicable and communicable diseases in the private health care sector of the eThekwini Municipality of KwaZulu-Natal and to describe the reasons for such behaviour. Methods: A self-reported anonymous medication adherence questionnaire was used to obtain data, from 233 private sector patients afflicted with HIV, Type 2 Diabetes Mellitus, Hypertension and Dyslipidaemia in the eThekwini Municipality of KwaZulu-Natal. The questionnaire focused on the adherence behaviour of these participants and factors that influenced their adherence behaviour. Medication adherence was determined by the number of days of medication missed during the last 30 days. Data was collected and analysed using SPSS. Results: Majority of participants were aged between 51-60 years (26.6%), and were of male gender (52.8%). An almost equal number of participants were afflicted with single disease (n=116) or multiple diseases (117). Hypertension was the most prevalent ailment (n=167), followed by Type 2 Diabetes (n=113), Dyslipidaemia (n=94) and HIV (n= 26). Over 62% of participants reported not missing any medication during the last 30 days. More than 21% had stated missing 1-2 days of their medication and 15.9% reported missing 3 or more days of medication during the last 30 days. With regards to single ailment, the highest percentage of adherence was reported in participants afflicted with Hypertension (60.6%), and Type 2 diabetes (58.3%). HIV and Dyslipidaemia had the lowest rates of adherence as 45% (n=9) of HIV only and 57.1% (n=4) of Dyslipidaemia only afflicted participants reported missing 1 or more days of their medication. The highest rate of non-adherence was found amongst the age group of participants 51-60 years old, while the highest rate of adherence was found in the group aged 70 years+. Reasons for non-adherence included cost, forgetting to take medication, running out of medication, stopping medication because it made them feel worse or gave a side effect and having difficulty with time schedules or having medication with/without food. Conclusion: Participants afflicted with communicable and non-communicable diseases in the private health care sector have sub-optimal medication adherence. Although no significant correlations were found between having a particular disease and the rate of adherence, participants afflicted with HIV and Dyslipidaemia alone were the least adherent to their medication. Reasons for their nonadherence were similar to other studies reported