Factors associated with treatment non-adherence among adult cardiovascular patients attending outpatient cardiac clinic at jimma university teaching hospital southwest Ethiopia, jimma 2014.

Abstract

Treatment non- adherence is affected by a number of factors; among them psychiatric conditions especially depression is major. Treatment non-adherence among cardiovascular patients are a public health issue which results in hospitalization, poor quality of life, morbidity, increase in health cost and mortality. Even if this psychiatric condition were not addressed there were study conducted in Gondar and Debate woreda on treatment non compliance on chronic NCD. So this area is not addressed irrespective of its huge negative impact as there is scarcity of information in Ethiopia and particularly at Jimma. Objective – The general objective of this study was to assess factors associated with treatment non adherence with special emphasis on depression among adult cardiovascular patients attending service at outpatient cardiac clinic of JUTH from October – November, 2014 Methods- The study was conducted in Jimma University Teaching Hospital cardiac unit from October to November 2014 with a total sample of 353 patients which was cross-sectional. Depression status of cardiovascular patients were measured by using Patient Health questionnaire-9( PHQ 9) where the cutoff point were five from the total 27 scores. Score of less than five was taken as non depressed and greater than or equal to five as depressed. Treatment adherence status was measured by Morisky medication adherence scale 8 (MMAS 8) where scores less than six were taken as treatment adherent where as scores greater than or equal to six as non adherent. Oslow Social Support (OSS) 3 item scales was also used to assess the strength of social support of respondents. 95% confidence interval and variables with p value of less than 0.05 were taken as significant on the final model. Result- A total of 339 patients were interviewed making a response rate of 96%. Age group in the range of 36 to 44 with [AOR (95%CI)=4.4 (1.12-18.2)] and age group of 54 to 62 with [AOR (95%CI)=3.6 (1.02-14.1)], being divorced with [AOR (95%CI)=0.21 (0.05-0.8)], having moderate social support [AOR (95%CI)=(0.17-0.9)] and unavailability of medications in the hospital pharmacy with [AOR (95%CI) =0.2 (05-0.9)] were significantly associated with treatment non-- adherence of respondents. Conclusion: Age, being divorced, having moderate social support and unavailability of medication in the hospital pharmacy are factors which contribute for treatment non adherence. Depression was not statistically significant on the final model but its prevalence was high (63.1%) among the non adherent groups. So treatment adherence is a multi-factorial problem consideration should be given to alleviate this problem.