Prevalence and Determinants of Medication Adherence in Patients with Multi-morbidities attending General Outpatient Clinics in Secondary Health Care Facilities in Kaduna State

Abstract

Background: Multi-morbidity is a global public health issue which requires medication adherence to aid in the management. Poor adherence could lead to reduced quality of life, and mortality. This study was carried out to determine the prevalence and determinants of medication adherence among patients attending the general outpatient clinics in secondary health facilities in Kaduna State.

Methods: This was a hospital-based cross-sectional study carried out among 119 patients attending the general outpatient clinics in secondary health facilities in Kaduna State. Respondents were selected via multistage sampling technique. Data was obtained from the respondents using a pre-tested interviewer-administered questionnaire. Medication adherence was assessed with eight-item Morisky Medication Adherence Scale (MMAS-8). Data was analysed using IBM SPSS Statistics version 23. Statistical significance was set at a p-value of <0.05.

Results: Seventy-four (62.2%) of the respondents were aged at least sixty years. The mean age of respondents was 60.3±13.6 years. Seventy-six (63.7%) of the respondents had low medication adherence. The older age (≥60 years) of the respondents (AOR=6.19, 95%CI=1.42-4.81, p=0.001), lack of education (AOR=5.74, 95%CI=1.39-3.42, p<0.001), out-of-pocket spending (AOR=5.29, 95%CI=1.41-3.53, p<0.001), low monthly income (AOR=3.39, 95%CI=1.53-4.81, p=0.004) and taking over 4 medications (AOR=8.25, 95%CI=1.26-5.13, p=0.002) were found to be predictors of low medication adherence.

Conclusion: The finding of low adherence among majority of the respondents highlights the fact that achieving desired health outcomes will be a challenge. Improving this situation would require government interventions which are focused on social drivers of health as well as improving healthcare financing.