Care Management: Adherence to Therapies Among Patients at Bu-Alicina Clinic, Qazvin, Iran

Abstract

Background: Non-adherence to treatment is a problem of increasing concern for all stakeholders. This study was designed to determine the prevalence of non-adherence among the clients consulting internists or cardiologists at Bu-Alicina Clinic in Qazvin. Methods: A total number of 400 clients came to Bu-Alicina Clinic (center for internal medicine and cardiology) were randomly interviewed through a questionnaire during a two month period in 2003. Self-administered methods were used if the clients applied. The data were interpreted using statistical methods. Results: The clients were between 14 and 78 years old (33.7+8.5) and 57.5% of them were women and 42.5% were men. Of total number, 30.7% were consulting for continuation of their therapies and of these clients, 41.5% had pooradherence to their current therapies. The more educated clients were 1.6 times (OR=1.62; 95% CI=0.71, 3.74) likely to be more adherent to the therapies.There was no significant difference between the internal diseases patients and cardiology patients in this regard (41.7%vs 40%). Of the total number of 400 clients, 79.5% had history of consulting to medical clinics during the last three months and 37.4% of them had non-adherence to their past therapies. The more frequent factors were: forgetfulness (13.3%), not to be able to afford to pay for treatment costs (10.3%), disbelieve to the doctor and consulting another ones (8.4%), long distance (8.4%), feeling that it is not important to take medications (7.4%), side effects (7.4%), disbelieve to the diagnosis (7.1%), religious considerations (6.5%), and misunderstanding or lack of information about the prescription (5.8%). No significant difference was found between men and women on this aspect. Conclusion: Patients need advice, supported information from professionals about their health and therapies. Certain studies must be done to determine the pitfalls and effective interventions address that barriers can be developed. Keywords: adherence, non-adherence, non communicable disease