Factors Affecting Medication Adherence among Patients on Concomitant Tuberculosis and Antiretroviral Therapy in Kogi State Nigeria

Blessing Onyinye Ukoha-Kalu¹ , Florence Eichie² , Maxwell Ogochukwu Adibe³ , Chinwe Victoria Ukwe⁴

Section:Research Paper, Product Type: Journal-Paper
Vol.6 , Issue.6 , pp.129-134, Dec-2019

Online published on Dec 31, 2019

Copyright © Blessing Onyinye Ukoha-Kalu, Florence Eichie, Maxwell Ogochukwu Adibe, Chinwe Victoria Ukwe . This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
 

View this paper at   Google Scholar | DPI Digital Library

XML View     PDF Download

How to Cite this Paper

Abstract :
Non-adherence to antiretroviral (ARV) medications as well as drugs used to treat tuberculosis (TB) can lead to manifestations of drug-resistant strains of mycobacterium tuberculosis. This study aimed at assessing the level of medication adherence and its determinants among patients living with HIV/AIDS and TB co-morbidity. A well structured questionnaire for the study of ART and anti TB medication adherence and its determinants was designed and the validity of the questionnaires was assessed through in-depth discussion with experienced consultants working in the ARD/TB clinic of the Federal Medical Center, Lokoja. Primary outcome measure was medication adherence, while secondary outcome measures were health literacy of patients and patient relation with their healthcare providers. Data was extracted from completed questionnaires, coded and entered into the Microsoft excel sheet for statistical analysis using SPSS 16.0 A total of 450 patients that participated in the study were on antiretroviral and only 60 (13.3%) of them were co-infected with both HIV and tuberculosis and are on both ARV and TB medications. Majority of the respondents were male (63.3%) and are above 45 years of age. About 23 of the patients were said to be single, 20 patients were married, and 8 of them were divorced/separated while 17 of them were widowed. About 81.7% of the respondents have one form of education or the other. Less than half of the respondents have a source of income. 23 persons (38.3%) reported never to have missed their ARV’s while only 18 persons (30%) reported never to have missed their tuberculosis medications. About 8 patients (13.3%) for ARV’s and 10 patients (16.7%) for anti-TB reported ‘forgetfulness’ as the reason for missing their medications. Majority of the patients (31.7% for ARV’s and 18.3% for anti-TB) reported that experiencing side effects was the reason for missing their medications. Also most of the patients (11.7% for ARV’s and 20.0% for anti TB) said the reason they missed their medications was because they did not have money to transport themselves to the health facility. For the ARV’s, only 8 persons (13.3%) said the reason they missed their medications was because they were getting bored of the whole treatment or feeling worse about their condition. Only 5 persons (8.3%) for ARV’s and 3 persons (5.0%) said the reason they missed their medications was because they were already feeling better. 90% of the respondents reported good relationship with Physician. Forgetfulness, side effect and lack of money for transportation were the major reasons reported by the patients as to why they missed their medications, while gender, age, educational status and employment status do not play a significant role in the adherence of both the ARV’s and anti-TB therapy.

Key-Words / Index Term :
Adherence, HIV/AIDs, antiretrovirals, Tuberculosis, Anti-TB

References :
[1] E.L. Corbett, C.J. Watt, N Walker, D. Maher, B.G. Williams, M.C. Raviglione, C. Dye. “The Growing Burden of Tuberculosis. Global Trends and Interactions With the HIV Epidemic”, Arch Intern Med.,Vol. 9 Pg. 1009-1021, 2003.
[2] A. Kebede, N.T. Wabe. “Medication adherence and its determinants among patients on concomitant tuberculosis and antiretroviral therapy in South West Ethiopia”. North Am J Med Sci Vol 4, Pg 67-71, 2012.
[3] M.L. Scanlon, R.C. Vreeman. “Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings”. HIV/AIDS - Research and Palliative Care. Vol 5, Issue 7, Pg 1-17, 2013.
[4] A.A. Redal, S. Biadgilign. “Determinants of Adherence to Antiretroviral Therapy among HIV-Infected Patients in Africa”. AIDS Research and Treatment. Vol. 5, Pg. 65-6, 2012.
[5] J.A. Bartlett. “Addressing the challenges of adherence”. J Acquir Immune Defic Syndr Vol. 29, Pg2-10, 2002.
[6] J.M. Lange, J. Perriens, D. Kuritzkes, D Zewdie. “What policymakers should know about drug resistance and adherence in the context of scaling-up treatment of HIV infection”. AIDS Vol. 18, Pg. 69-74, 2004.
[7] K.A. Beyene, T. Gedif, T. Gebre-Mariam, E. Engidawork. “Highly active antiretroviral therapy adherence and its determinants in selected hospitals from south and central Ethiopia”. Pharmacoepidemiol Drug Saf Vol. 18, Pg 1007-15, 2009.
[8] 8.M.B. Cauldbeck, C. O’Connor, M.B. O’Connor, J.A. Saunders, B. Rao, V.G Mallesh. “Adherence to anti-retroviral therapy among HIV patients in Bangalore, India”. AIDS Res Ther Vol. 6, Pg. 7, 2009.
[9] C. Orell. “ART adherence in resource poor setting”. Curr HIV/AIDS Rep Vol. 2, Pg 171-6, 2005.
[10] J. Okuno, H. Yanagi, S. Tomura. “Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community”? Eur J Clin Pharmacol Vol. 57, Pg. 589-94, 2001.
[11] F.D. Goebel. “Combination therapy from a clinician’s perspective”. J Acquir Immune Defic Syndr Vol. 10, Pg 62-68, 1995.
[12] S. Vella. “HIV pathogenesis and treatment strategies”. J Acquir Immune Defic Syndr Vol. 10, 20-23, 1995.
[13] J. Cinatl Jr, J. Cinatl, H. Rabenau, H.W. Doer, B. Weber. “Failure of antiretroviral therapy: role of viral and cellular factors”. Intervirology Vol. 37, 307-314, 1994.
[14] L. Moutouh, J. Corbeil, D.D. Richman. “Recombination leads to the rapid emergence of HIV-1 dually resistant mutants under selective drug pressure”. Proc Natl Acad Sci USA Vol. 10, 6106-6111, 1996.