Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

Abstract

Introduction: proper management of chronic diseases is important for prevention of disease   complications and yet some patients miss appointments for medical review thereby missing the   opportunity for proper monitoring of their disease conditions. There is limited information on missed  appointments among chronic disease patients in resource limited settings. This study aimed to   determine the prevalence of missed appointments for medical review and associated factors among  chronic disease patients in an urban area of Uganda.

Methods: patients or caregivers of children with chronic diseases were identified as they bought  medicines from a community pharmacy. They were visited at home to access their medical documents  and those whose chronic disease status was ascertained were enrolled. The data was collected using: questionnaires, review of medical documents, and in-depth interviews with chronic disease patients.

Results: the prevalence of missed appointments was 42% (95%CI=35-49%). The factors associated with missed appointments were: monthly income ?30US Dollars (OR=2.56, CI=1.25–5.26), affording less than half of prescribed drugs (OR=3.92, CI=1.64–9.40), not experiencing adverse events (OR=2.66, CI=1.26–5.61), not sure if treatment helps (OR=2.84, CI=1.047.77), not having a medicines   administration schedule (OR=6.77, CI=2.11–21.68), and increasing number of drugs (OR=0.72,  CI=0.53–0.98).

Conclusion: patients missed appointments mainly due to: financial and health system barriers,  conflicting commitments with appointments, and perceptions of the disease condition. Patients should be supported with accessible and affordable health services

Key words: Chronic disease, medical review appointments, missed appointments