Abstract

This study of assessing the factors influencing medication noncompliance amongst patients in the Buea Regional Hospital was to bring forth different factors which influence medication noncompliance. Thus the objective of this study was to assess the knowledge of the importance of medication noncompliance amongst these patients and to create awareness about the effects of medication noncompliance.

The target population was 152 participants. Data was collected coded using a well-structured questionnaire, pen, pencil which was prepared in English language and carried both open and close ended questions, and entered in a computer using Microsoft excel 2013 and analyze using statistical package for social science (SPSS) Software version 23.

Result showed that majority of these participants (65%) were of the point of view that medications sometimes could be expensive been a reason why patients wont comply with it and 6% did not know what to say regarding this factor. Base on the result obtain 58% defined medication compliance as adhering to medication as prescribed and 4% defined it has taken medication without prescription.

CHAPTER ONE

INTRODUCTION

1.1 Background Study

Medication noncompliance is defined as a patient’s medication-taking behavior that does not comply with recommendations from healthcare providers (Osterberg et al., 2005).

Medication noncompliance continues to be a significant challenge in healthcare, and there is a shortage of effective interventions in this area. Medication noncompliance can be defined as the extent to which a patient’s behavior does not correspond with the prescribed medication dosing regimen, including time, dosing and interval of medication intake (Cramer et al., 2008, Vrijens et al., 2012).

It is a crucial point for the success and safety of many therapies (Martin-Ruiz et al., 2018, Kim et al., 2018, Bitton et al., 2013). Medication noncompliance is a widespread problem that causes high costs worldwide (Bitton et al., 2013, Cutler et al., 2018, Laufs et al., 2011, Brown et al., 2011, Hansen et al., 2009, Sabate, 2018). Especially in chronic conditions with long-term therapies, noncompliance is important to achieve target outcomes but is often low (Sabate, 2018).

Noncompliance is a multifactorial phenomenon that can be influenced by various factors. These factors can be divided into five different dimensions: social and economic factors, therapy-related factors, disease-related factors, patient-related factors and health care system-related factors (Sabate, 2018, Schäfer. 2017). Some factors can have an influence on intentional non-compliance (conscious decision not to take the medication; e.g., because of high co-payments), while others can have an influence on non-intentional (forgetting) non-compliance (e.g., forgetfulness because of mental comorbidity).

Insights into the factors that might have a negative influence on noncompliance are important for several reasons. First, this information can support the identification of patients at high risk for non-compliance. Second, it can support the identification of possible compliance barriers that might be eliminated.

Third, it can support the development of individually tailored compliance-enhancing interventions. Evaluating medication noncompliance in the mental health sector for instance, in order to maintain treatment effectiveness and prevent relapse, it is important for patients with severe mental disorders, such as schizophrenia, bipolar disorder and major depressive disorder, to keep taking their medications continuously over the long term Lehman (AF et al., 2004, Galletly et al., 2016, American Psychiatric Association. 2000). In Africa, medication noncompliance is reported as high at 62.5%, while the global rate remains at 45.3% (Abegaz et al., 2017; Weldegebreal et al., 2019). In sub-Saharan Africa, there have been a steady increase in the hypertension prevalence from 9.7% (1990) to over 30.8% (2010) as current prevalence is estimated to range from 15% to 70% (Adeloye, 2014; Ataklte et al., 2015; Mills et al., 2016).

One of the surest ways for the control of hypertension is the use of medications for a lifetime (Abegaz et al, 2017; Agbor et al, 2018; Weldegebreal et al, 2019). In unipolar depression, the estimated non-compliance rates ranged from 13% to 52.7% (Ten-Doesschate et al., 2009A study carried out in Buea (Cameroon) in 2014 revealed that only 66.7% of hypertensive patients were noncompliant with their antihypertensive drug therapy (Adidja, 2014).

Another study performed in 2012 in Cameroon revealed that only 59.9% of known hypertensive patients were taking antihypertensive drugs, despite being aware of their condition (Dzudie et al., 2012). The reasons for this poor compliance need to be better understood if they are to be modified. Despite compelling evidence on noncompliance to antidiabetic medications and its consequences elsewhere, there is paucity of information in patients with diabetes in Cameroon. Studies have indicated that noncompliance is influenced by a number of issues, including side effects, cost of the medication, dosing frequency, and routes of administration.

Other factors include patient beliefs, demographics and comorbidities. Some studies have also identified a perceived lack of benefit from the medications. Understanding these factors can help providers improve therapeutic outcomes for patients. The purpose of the current study was therefore to investigate the factors that influence medication noncompliance among patients in the Buea Regional Hospital, SWR of Cameroon.

1.2 Problem statement

It has been identified by various studies that there exist challenges within the health sector related to medication noncompliance and its wide range of influencing factors. Medication non-compliance is associated with poorer health outcomes (Rasmussen et al., 2017). If patients do not gain the expected health benefits from their medication because of non-compliance, the burden of health care costs increases for both patients and society in general (Roebuck et al., 2011, Iuga et al., 2014, Cutler et al., 2018).

Not taking the right dose or abandoning treatment altogether can exacerbate a patient’s health condition, increase the risk of disease progression, and lead to prolonged hospitalization. Non-compliance doesn’t just affect individual patients and their loved ones, it also takes a financial toll on our healthcare system and taxpayers.

Research has found that morbidity and mortality associated with poor medication compliance leads to high costs. By making it easier for patients to follow their prescription regimens, we can keep people healthier while reducing unnecessary strain on the economy. This led to the conception of the current study which focuses on the factors that influence medication noncompliance among patients in the Buea Regional Hospital, SWR of Cameroon.

1.3 Research Questions

1. What knowledge do patients have about the importance of medication compliance in the Buea Regional Hospital?
2. What are the factors that influence medication noncompliance among patients in the Buea Regional Hospital?

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