Patients’ Perception of Factors Influencing Noncompliance with Medication among Cardiac Patients in Fiji: A Qualitative Study

Avnit Kumar,1 Masoud Mohammadnezhad,2 William May3 1Department of Primary Care and Nutrition, Fiji National University, Suva, Fiji Islands; 2Department of Public Health and Health Services Management, Fiji National University, Suva, Fiji Islands; 3Department of Internal Medicine, Fiji National University, Suva, Fiji IslandsCorrespondence: Masoud MohammadnezhadDepartment of Public Health and Health Services Management, Fiji National University, Suva, Fiji IslandsEmail masoud.m@hotmail.comBackground: Noncompliance with prescribed medication leads to disease progression, which often leads to premature deaths. It often leads to worsening symptoms of cardiac conditions and hospitalization. Due to the lack of previous research, this study aimed to explore the factors contributing to noncompliance with medication in cardiac patients in Fiji.Methods: This qualitative study was conducted among 25 cardiac patients with congestive heart failure and coronary heart disease who attended special outpatient department (SOPD) clinics at Sigatoka Subdivisional Hospital in Fiji. Purposive sampling was used to select the study sample, and in-depth face-to-face interviews were conducted using a semistructured, open-ended questionnaire. Data were analyzed using thematic analysis, whereby the data collected were grouped in subthemes and then common themes related to the topic.Results: A total of 25 patients were interviewed, with a majority (n=14) being men and 15 Fijian of Indian descent. A greater number (n=17) of participants were above the age of 60 years, 19 had had primary education, while 12 were unemployed. Eight themes were identified as factors affecting noncompliance with medication: scarcity of knowledge, patients’ negative attitudes, poor family support, financial constraints, forgetfulness, irregular clinic attendance, heavy alcohol use, and alternative treatment vs pharmaceutical medication.Conclusion: Noncompliance with medication in cardiac patients contributes to worsening cardiac disease and premature deaths. For factors related to noncompliance, awareness can be raised in SOPD clinics for patients to realize the effects of noncompliance and provide ways to improve compliance. Providing professional counseling services for all SOPD patients would greatly help in increasing compliance with medication in Fiji.Keywords: determinants, noncompliance with medication, cardiac patients, qualitative study, Fij